case_images: PMC11724702_01
case_images: Coronal view computed tomography of the abdomen and lower chest shows an air-fluid level associated with mild thickening of the diaphragmatic crus, abnormal fistulous communication between the fundus and left lung, and adjacent lung consolidation.
case_images: LS-JSLS240031F001.jpg
case_images: PMC11724702_01_LS-JSLS240031F001.jpg
case_images: F1
case_images: CT of the abdomen with oral contrast showed abnormal fistulous communication between the fundus and left lung (Figure 1).
case_images: Upper endoscopy shows a retaining prolene suture from previous surgery, clips, and two patent tracks going to the pleura.
case_images: LS-JSLS240031F002.jpg
case_images: PMC11724702_01_LS-JSLS240031F002.jpg
case_images: F2
case_images: Upper endoscopy was performed as part of the management (Figure 2), and the first trial of endoscopic stenting was offered to the patient but failed due to slippage (Figure 3).
case_images: X-ray fluoroscopy of gastrografin shows that part of the contrast passed through a fistula into the bronchial tree of the left lower lung lobe.
case_images: LS-JSLS240031F003.jpg
case_images: PMC11724702_01_LS-JSLS240031F003.jpg
case_images: F3
case_images: Upper endoscopy was performed as part of the management (Figure 2), and the first trial of endoscopic stenting was offered to the patient but failed due to slippage (Figure 3).
case_images: X-ray of chest and abdomen shows stent migration of its original place; based on the images and the recurrence of symptoms (cough, nausea, and vomiting), slippage was confirmed.
case_images: LS-JSLS240031F004.jpg
case_images: PMC11724702_01_LS-JSLS240031F004.jpg
case_images: F4
case_images: Radiography of the chest and abdomen revealed a second slipped stent (Figure 4).
case_images: X-ray fluoroscopy of gastrografin shows that contrast passes smoothly through the esophagus, gastroesophageal junction, and down to the remaining part of the stomach to proximal jejunal loops without obstruction.
case_images: LS-JSLS240031F005.jpg
case_images: PMC11724702_01_LS-JSLS240031F005.jpg
case_images: F5
case_images: A postoperative UGI contrast study was obtained prior to discharge and revealed no evidence of leak, definite fistula tract, or contrast leak (Figure 5).