60 year old male with eso...

A 60-year-old male, a smoker, with a known history of esophageal carcinoma and stricture undergoing chemotherapy. Esophageal stenting had been previously performed elsewhere to address the stricture. The patient was referred for evaluation of cough and respiratory distress. Bronchoscopy revealed bulging of the posterior wall and significant luminal narrowing of the mid and lower trachea due to extrinsic compression from the esophageal stent. Erosion of the posterior wall of the left main bronchus was observed, along with the visualization of the esophageal stent at the eroded site with bleeding. The procedure involved rigid bronchoscopy and the placement of a self-expanding metallic Y airway stent (18*6 mm). The outcome was successful, leading to complete restoration of the airway lumen and significant relief of respiratory distress. The patient was successfully extubated on the operating table. Several technical challenges were encountered during the case. The deployment of the Y stent proved to be technically challenging, with the deployer displaced to the right side due to extrinsic compression from the esophageal stent. Rigid bronchoscopic forceps were utilized to align the deployer to a neutral position within the limited working space. To prevent displacement during deployment, the stent was held with rigid bronchoscopic forceps. Additionally, the sizing of the stent was deemed extremely crucial, as a smaller size increased the risk of post-deployment displacement due to extrinsic compression. The procedure also encountered significant bleeding from the eroded, edematous tracheal mucosa.