Endoluminal Vacuum Therapy for Esophageal Anastomotic Leakage Following Multivisceral Transplantation: A Case Report

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Author Info

Anna Laureys Stijn Vanstraelen Caroline Boelhouwer Lucas Wauters Ingrid Demedts Hans Van Veer Lieven Depypere Laurens J Ceulemans Jacques Pirenne Tim Vanuytsel Philippe Nafteux

Corresponding Author

Philippe Nafteux
Department of Thoracic Surgery, University Hospital Leuven, Leuven, Belgium

A B S T R A C T

Background: Esophageal anastomotic leakage is a rare but potentially life-threatening complication, especially following complex surgical procedures like multivisceral transplantation. Endoluminal negative pressure therapy (ENPT) has emerged as a promising, minimally invasive strategy to treat gastrointestinal anastomotic leakage outside the setting of immunosuppression. However, its application in transplant recipients has not been described yet. Case Presentation: We report the case of a 47-year-old woman who underwent multivisceral transplantation due to diffuse splanchnic ischemia, secondary to celiac trunk and superior mesenteric artery thrombosis. Postoperatively, she developed persistent epigastric pain and respiratory distress, prompting ICU readmission. A CT-scan and upper endoscopy revealed an anastomotic leakage at the level of the esophago-gastric anastomosis. Given her clinical condition, ENPT therapy was chosen after multidisciplinary discussion. A VACStent® prosthesis was positioned endoscopically. Three ENPT sessions resulted in complete resolution of the anastomotic leakage, which was confirmed on contrast gastrografin swallow radioscopy. Conclusion: Our case illustrates the potential of ENPT in immunocompromised high-risk patients. Consequently, it may be considered a safe and effective alternative to surgical or prosthetic interventions, emphasizing the expanding role of advanced endoscopic therapies in complex postoperative scenarios.

Article Info

Article Type

Case Report

Publication history

Received: Tue 20, Jan 2026
Accepted: Mon 23, Feb 2026
Published: Mon 01, Jun 2026

Copyright

© 2023 Philippe Nafteux. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.TCR.2026.01.01