Endoscopic management of complications related to esophageal stenting by repositioning the stent without extraction or re-stenting.

A 65-year-old man was treated for a tracheo-esophageal fistula between the right main bronchus and the mid-portion of the esophagus, due to mediastinal lymphadenopathy in acute myeloid leukemia. A covered expandable esophageal stent (Ultraflex, Microvasive/Boston Scientific), 15 cm in length, was inserted under fluoroscopic control. Sealing of the fistula was complete, as confirmed by barium studies. The patient was readmitted a week later due to recurrent symptoms. Barium studies revealed distal migration of the stent by about 2 cm and consequent reopening of the orifice (Figure 1).