Causes of obstruction of prosthetic esophageal tubes and their prevention: a case report and review of the literature.

A case of Celestin tube obstruction in a 57-year old patient is presented. Obstruction in this case was secondary to three mechanisms: distal mucosal prolapse, intraluminal suture web and food impaction. Prosthetic intraesophageal devices are subject to a number of complications, obstruction being the most frequent. A review of various types of prosthetic tube obstruction are given with emphasis on food impaction. Correct technic on tube insertion and dietary guidance are the best means of insuring tube patency. Guidelines for treating food impaction before endoscopic retrieval are suggested. Papain solution should be taken orally, first. If this is unsuccessful, nasogastric suction over the obstruction and local instillation of papain solution should be the next step. Finally, endoscopic confirmation of the obstruction is performed followed by gentle pulsion on the obstructing particle with a flexible cytology brush.