Endoscopic Stenting in the Management of Gastrointestinal Perforations.

Foregut perforations, often iatrogenic from endoscopy or spontaneous, pose high morbidity and risk of fistula and sepsis. The esophagus is the primary target for stenting due to its less tortuous anatomy and layered wall without serosa, influencing injury spread and fixation choices. Preprocedural planning requires cross-sectional imaging review, assessment of nutrition and airway risk, anesthesia consultation, and selection of a covered self-expandable stent sized to cover the defect with 2 cm margins. Positioning, carbon dioxide insufflation, and availability of clips or suturing for fixation are essential.