Stent migration to the ileum: a potentially lethal complication after Montgomery salivary bypass tube placement for hypopharyngeal stenosis after laryngectomy.

Abstract

Montgomery salivary bypass tubes (MSBTs) have been used for decades in the treatment of stenoses and fistulae of the hypopharynx and the cervical esophagus. Generally, MSBT use is not associated with serious complications. Only a small number of cases with severe MSBT-associated complications have been reported in the literature. We report for the first time an MSBT migration to the ileum in a laryngectomized patient who underwent surgical pharyngocutaneous fistula closure with MSBT placement. The MSBT was removed surgically via laparotomy. The patient died 15 days later due to sepsis associated with peritonitis. To avoid potentially lethal complications associated with MSBT migration into the intestinal tract, we recommend secure fixation of the MSBT to a nasogastric tube.