A rare case of a chest wall abscess caused by a migrating oesophageal stent. An iatrogenic gastrocutaneous fistula

We report the case of a 65-year-old male, who presented with septicaemia and a chest wall mass on a background of oesophageal carcinoma. This chest wall mass measured 10 cm by 10 cm, was fluctuant, and was situated on the anterior chest wall. Owing to local erythema and surgical emphysema, necrotisi...

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Veröffentlicht in:BJR case reports 2017-01, Vol.3 (3), p.20160138
Hauptverfasser: Karthigan, Ravindran, Townsend, Matthew, Chan, Nathan, Kaderbhai, Husein, Tabbakh, Yasmin, Leyte Golpe, Antonio, Rudran, Branavan, Hadjittofi, Christopher, Zar, Sameer, Pissas, Dimitrios, Burney, Kashif
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container_issue 3
container_start_page 20160138
container_title BJR case reports
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creator Karthigan, Ravindran
Townsend, Matthew
Chan, Nathan
Kaderbhai, Husein
Tabbakh, Yasmin
Leyte Golpe, Antonio
Rudran, Branavan
Hadjittofi, Christopher
Zar, Sameer
Pissas, Dimitrios
Burney, Kashif
description We report the case of a 65-year-old male, who presented with septicaemia and a chest wall mass on a background of oesophageal carcinoma. This chest wall mass measured 10 cm by 10 cm, was fluctuant, and was situated on the anterior chest wall. Owing to local erythema and surgical emphysema, necrotising fasciitis was suspected and thus intravenous antibiotic and fluid therapy were instituted. Following a chest radiograph, which confirmed the presence of subcutaneous gas, the patient underwent thoraco-abdomino-pelvic CT, which demonstrated oesophageal stent migration through the gastric fundus to the chest wall, between the 10th and 11th left ribs. Through this migration tract, the chest wall was contaminated with gastric contents, accounting for the mass and sepsis. The patient underwent endoscopic stent removal, and incision and drainage to create a gastrocutaneous fistula. Additionally, a nasojejunal tube and intravenous line were sited for jejunal and total parenteral nutrition, respectively, in order to promote healing of the fistula.
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title A rare case of a chest wall abscess caused by a migrating oesophageal stent. An iatrogenic gastrocutaneous fistula
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