부산대학교 도서관

Case description. We present the case of a 71-year-old female patient who came to the ER complaining of intermittent dysphagia for solids and liquids in the last 2-3 weeks, having had a laparoscopic hiatus hernia repair with a Nissen's fundoplication one month ago. Upper GI endoscopy confirmed the presence of a tight gastroesophageal junction stenosis, at the level of the fundoplication. The case was discussed by a multidisciplinary team, and surgical treatment was advised. After the surgical intervention, the patient developed a perianastomotic fistula, which was treated endoscopically using an FC-SEMS. After an initial stent migration, the stent was fixed using clips, and the barium swallows showed no contrast extravasation. After 8 weeks, the patient presented to the ER with hematemesis, caused by a distal stent migration causing a gastric contact ulcer. The stent was extracted, and complete fistula closure was observed. Discussion. The role of endoscopic treatment in cases of postoperative dysphagia. Other treatment options when dealing with an esophageal fistula: OTSC, vacuum therapy, glue injection, and endoscopic suturing. [ABSTRACT FROM AUTHOR]