Patient stay in the intensive care unite intubated ventilated on sedation after stenting for 10 days then extenuated and kept for conservative treatment till discharged from the hospital on 16/3/2015, in which appointment given for him for follow up appointment in surgical out patient, in the following visit , patient was looking well from surgical side chest clear no dyspepsia no limitation of chest movement, wound clean, well healed no swelling, the abdomen soft not distended with normal bowel habit.