Endoscopic Stenting in the Management of Gastrointestinal Perforations.

Saam Dilmaghani, Nayantara Coelho-Prabhu

Journal: Gastrointestinal endoscopy clinics of North America 2026;36(2):337-348

PMID: 41905796

Full Text on Elsevier Science View on PubMed

Abstract

Foregut perforations, often iatrogenic from endoscopy or spontaneous, pose high morbidity and risk of fistula and sepsis. The esophagus is the primary target for stenting due to its less tortuous anatomy and layered wall without serosa, influencing injury spread and fixation choices. Preprocedural planning requires cross-sectional imaging review, assessment of nutrition and airway risk, anesthesia consultation, and selection of a covered self-expandable stent sized to cover the defect with 2 cm margins. Positioning, carbon dioxide insufflation, and availability of clips or suturing for fixation are essential.

Address: Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.; Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Electronic address: [email protected].

DOI: 10.1016/j.giec.2025.12.006

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MeSH Terms: Humans, Stents, Esophageal Perforation, Endoscopy, Gastrointestinal, Intestinal Perforation