The Utility of Covered Self Expanding Metal Stents in the Management of Complex Small Bowel Fistula

Endoscopic procedures and stent technology innovations have significantly developed their usage in gastrointestinal illnesses. The use of stents in the GI tract has expanded to encompass a wide range of malignant and benign diseases and anatomical sites. However, whether covered self-expanding stents can help control postoperative small bowel leaks and fistulas is still not answered. Stent's utility in managing bowel leaks and fistulas is rarely reported, and no adequate evidence in the literature concerning its benefits and limitations. A 63-year-old patient had numerous surgeries for recurrent adhesive intestinal obstruction. The patient repeated laparotomies were complicated with multiple minor bowel injuries, high output complex enterocutaneous fistulas, extensive leaks, nutritional depletion, and major wound and skin breakdown. This report describes our approach for deploying covered self-expanding metallic stents (SEMS) in the small bowel to manage high output complex enterocutaneous fistulas in this patient. The clinical benefits and drawbacks of such clinical applications are described, and the problems and difficulties experienced.