Benign Esophageal Perforation – Non-Surgical Management

Surgery is usually considered a treatment for acquired benign esophageal perforation but in sick patients’ surgery is not possible. We report a case of mid esophageal perforation, detected during side-viewing endoscopy. As the surgery was difficult considering her age and comorbidities, a fully covered, a self-expandable metallic stent (FC-SEMS) was placed over perforation, which was tied by plastic wire from the proximal end of FC-SEMS and anchored to the tooth (canines) to prevent inward migration. FC-SEMS was removed after three months and complete closure of esophageal perforation was achieved. This is probably the first case report in which one end of the plastic thread was tied to FC-SEMS (proximal end) endoscopically and another end of plastic thread tied to teeth to prevent inward migration after stent deployment.