A case of decisive material degeneration of an esophageal Celestin tube is described:
a 50-year-old man with adenocarcinoma of the distal esophagus received a Celestin
tube for palliative endoscopic treatment and 8 months later presented with suddenly
occurring complete dysphagia. Dissolution of the latex layer in the proximal as well
as the distal part of the tube had caused self-disintegration of the Celestin tube
and had liberated the monofilament nylon coil which completely obstructed the lumen
of the tube. Endoscopic tube removal was only possible by careful attachment of a
balloon catheter and peroral extraction after insufflation with contrast medium up
to 5 atm. A Medline-based review of the literature revealed different but predominantly
severe complications (perforation, hemorrhage, obstruction, and peritonitis) based
on material fatigue of the latex layer in esophageal Celestin tubes. At least 6 months
after placement of a Celestin tube, regular fluoroscopic controls should be performed
to detect early disintegration of the tube. Indication for the placement of Celestin
tubes in patients with benign esophageal strictures and longer life expectancy should
be assessed very critically.
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Chr. Löser
I. Medizinische Universitätsklinik Kiel
Schittenhelmstrasse 12 24105 Kiel Germany
Fax: Fax:+ 49-431-5971302
eMail: E-mail:chr.loeser@1med.uni-kiel.de
