- Joined
- Aug 25, 2012
- Messages
- 43
- Reaction score
- 4
Stage III-ish distal esophageal SCC, hepatogastric nodes +
- dysphagia to liquids
- Patient with leukocytosis, fever, CXR concerning for PNA (presumably aspiration)
- reports history of vomiting (6-7x per day), states tastes like acid (gastric contents?)
- primary team feels patient aspirating saliva 2/2 esophageal obstruction and have no end point to antibiotic coverage with their working diagnosis of aspiration PNA
They want to know if they should consider placing a stent to relieve the obstruction.
- on induction chemo
- likely to undergo chemoXRT in the next 2 weeks
We are hesitant to place one given risk of increasing aspiration after stenting and possible complications placing one (perforation, hemorrhage, erosion during chemo/XRT, etc) but not totally opposed
We do not feel complete obstruction since patient complaining of acidic tasting vomitus with coloration consistent with gastric contents
Would you recommend a stent in such a patient?
If so, why?
If not, under what circumstances would you stent?
What, if any, special considerations must there be if/when undergoing XRT with a stent in place
Of note, patient has a functioning peg in place.
- dysphagia to liquids
- Patient with leukocytosis, fever, CXR concerning for PNA (presumably aspiration)
- reports history of vomiting (6-7x per day), states tastes like acid (gastric contents?)
- primary team feels patient aspirating saliva 2/2 esophageal obstruction and have no end point to antibiotic coverage with their working diagnosis of aspiration PNA
They want to know if they should consider placing a stent to relieve the obstruction.
- on induction chemo
- likely to undergo chemoXRT in the next 2 weeks
We are hesitant to place one given risk of increasing aspiration after stenting and possible complications placing one (perforation, hemorrhage, erosion during chemo/XRT, etc) but not totally opposed
We do not feel complete obstruction since patient complaining of acidic tasting vomitus with coloration consistent with gastric contents
Would you recommend a stent in such a patient?
If so, why?
If not, under what circumstances would you stent?
What, if any, special considerations must there be if/when undergoing XRT with a stent in place
Of note, patient has a functioning peg in place.
