Abstract
A 51-year-old man was admitted to our hospital with a complaint of difficulty in swallowing and cough. He had previous surgeries for gastric ulcer and pancreatic cancer. After admission, endoscopic examination revealed a severe stenosis in the jejunum 45cm from incisional teeth 5cm distal to the esophago-jejunal anastomotic site, and multiple fistulae were seen near the lesion. We diagnosed it as a malignant stricture due to recurrent pancreatic cancer complicated with jejunobroncial and jejunocutaneous fistulae which was considered to be inoperable. A covered self-expandable metallic stent was inplaced at the site of the stricture and fistulae. Bndoscopically the stricture was remitted and the fistulae were sealed, and the patient's oral intake was much improved soon. This experience suggested that the use of covered self-expandable metallic stent for jejunobronchial and jejunocutaneous fistulae with malignant stenosis is an alternative for the patients in a grave condition.
