Postoperative Ischemic Jejunal Stenosis Treated with Balloon Catheter Dilation and Wallstent Implantation

Abstract

Ischemic stenosis of the jejunum is rare. For technical, anatomical, and pathological reasons, ischemic stenosis of the jejunal segment used for the replacement of the esophagus or the stomach, or both, represents a special entity. The present study reports a case of balloon catheter dilation of ischemic strictures of the jejunal segment, used for substitution after gastrectomy. In this patient, an occlusion of the blood vessels supplying the affected segment was observed at its aortic origin, and a Wallstent was implanted. A rare late complication, aortoesophageal fistula, appeared one year after placement of the Wallstent. The case presented in this study suggests that using balloon catheters and implanting a Wallstent may be a useful approach to the management of postoperative ischemic strictures of the jejunum in selected cases. The minimally invasive technique with special indications used here has not previously been described. The rare complication mentioned, however, requires special attention.