Control of Oesophageal Tumour-related Bleeding with a Fully Covered Self-expandable Metallic Stent (SEMS) Insertion

Abstract

The role of metallic stents in the management of refractory variceal bleeding is now well established however, they have been rarely used in the treatment of malignant gastrointestinal (GI) tract bleeding. To our knowledge, there are only three case reports in this regard, where fully covered self-expandable metallic stents (SEMS) were placed for the treatment of bleeding duodenal tumours. We have shared an experience of a novel and successful treatment of the oesophageal tumour-related bleeding with a fully covered SEMS. The 49-year male with oesophageal cancer presented with haematemesis and had received neo-adjuvant chemotherapy 3 weeks back. Upper GI endoscopy revealed an obstructing distal oesophageal tumour with the diffuse oozing of blood. While injection of adrenaline over a large ulcerated surface area was not possible, an attempt to treat it with hemospray was also unsuccessful. Thus, a temporary fully covered SEMS was inserted across the tumour to create a tamponade effect which resulted in the immediate cessation of the bleeding. This was endoscopically removed after a week and there was no further bleeding in one-month follow-up.