P1029 ESOPHAGEAL STENOSIS CONSEQUENT TO CAUSTIC INGESTION: STILL USEFUL THE BALLOON DILATATION

Background: Benign esophageal strictures are not rare. Over the past two decades, endoscopic balloon dilatation (EBD) has been used to treat them. Objectives: The purpose of this study was to identify the most common causes of benign esophageal stricture in children determine the success rate of endoscopic balloon dilatation. Methods: Children younger than 16 years with benign esophageal strictures referred to the endoscopy department during one year (2016 - 2017) were enrolled. After obtaining written consent from parents, endoscopy balloon dilatation was performed with two types of balloon catheters. Response to treatment was evaluated based on clinical symptoms and was classified according to the Vantrappen table score. Results: In this study, thirty-one (31) children participated including 19 (61%) boys and 12 (39%) girls. The mean age was 5.1 ± 3.9 years. The most common causes of esophageal stricture were: achalasia (45%), esophageal atresia (19%), stenosis due to the caustic ingestion (19%), another congenital stenosis (16%). Overall, 27 children (87.1%) had a good response to treatment. In children with stenosis due to caustic ingestion, the inappropriate response was higher than the rest (33%). However, only in 4 (12.9%) patients, balloon dilatation failed. No complications were observed. Conclusions: Achalasia, esophageal atresia, and caustic ingestion are the most common cause of benign esophageal stricture in the children. EBD is an effective and safe treatment in these children, even in cases of previous surgery and recurrence. If this procedure is performed by an expert using appropriate balloon catheters, no complications will be created.

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Indwelling Balloon Dilatation for Esophageal Stenosis in Infants

Journal of Pediatric Gastroenterology and Nutrition ◽

10.1097/01.mpg.0000189343.46257.41 ◽

2006 ◽

Vol 42 (4) ◽

pp. 437-439 ◽

Cited By ~ 3

Author(s):

David C. van der Zee ◽

N. M. A. Bax ◽

J. E. A. R. de Schryver ◽

F. J. A. Beek

Keyword(s):

Balloon Dilatation ◽

Esophageal Stenosis

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Extensive caustic esophageal stricture in children can be treated by serial dilatations interspersed with silicone-covered nitinol stenting

Journal of Digestive Endoscopy ◽

10.4103/0976-5042.195768 ◽

2016 ◽

Vol 07 (04) ◽

pp. 155-157

Author(s):

Veronica Alonso ◽

Harsha Nalluri ◽

Juan Carlos de Agustín

Keyword(s):

Esophageal Stricture ◽

Single Case ◽

Esophageal Stenosis ◽

Caustic Ingestion ◽

Endoscopic Dilatation ◽

Fluoroscopic Guidance ◽

Esophageal Dilatation ◽

Proximal Esophagus ◽

Resection And Anastomosis ◽

Caustic Stricture

AbstractRecurrent esophageal stenosis secondary to caustic ingestion may be challenging to treat. Self-expandable esophageal stents may be an alternative to repetitive endoscopic esophageal dilatation. We report a case of a 2-year-old male child with an extensive esophageal caustic stricture successfully treated using a combination of endoscopic dilatation and stenting. After 5 months of serial balloon dilatations, three nitinol internal silicone covered self-expandable stents were placed through the patient’s gastrostomy spanning the entire esophagus. The stents were positioned using a combination of both endoscopic and fluoroscopic guidance. The procedure was repeated with only one stent 3 months later. A new stricture in the proximal esophagus needed surgical resection and anastomosis, followed by two pneumatic dilatations with progressively longer asymptomatic intervals. The results are promising with the patient able to use his own esophagus; however, this is a single case and optimal stent standing time is still to be determined.

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Tucker Retrograde Esophageal Dilatation 1924–1974

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894740830s601 ◽

1974 ◽

Vol 83 (6_suppl) ◽

pp. 3-35

Author(s):

John A. Tucker ◽

Harvey D. Silberman ◽

Myles L. Turtz ◽

Gabriel F. Tucker

Keyword(s):

Diagnostic Technique ◽

Historical Review ◽

Esophageal Stenosis ◽

Caustic Ingestion ◽

Esophageal Dilatation ◽

Esophageal Obstruction ◽

Laryngeal Stenosis ◽

Complete Reversal ◽

Medical Approach ◽

Corrosive Ingestion

Emphasis has been placed on a historical review of corrosive ingestion in the last 175 years with particular reference to etiology, diagnostic technique, therapy and sociologic factors. A complete reversal of the medical approach, i.e., from therapy of cicatricial stenosis to prevention of the formation of esophageal stenosis, has occurred. The reasons for and methods of this change have been presented. Tucker retrograde bougienage as a valued technique in the therapy of severe esophageal obstruction has withstood the “test of time.” Its minimal application has to date included many thousands of patients. Current figures from the manufacturer indicate a steady distribution rate of 10 sets/month. Its indication and application has broadened from caustic ingestion to include congenital, acquired, severe esophageal, hypopharyngeal and even cases of laryngeal stenosis. The necessity for the use of Tucker retrograde bougienage has, thankfully, greatly diminished.

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A Case of Corrosive Esophagitis in Lao People's Democratic Republic

International Surgery ◽

10.9738/intsurg-d-16-00205.1 ◽

2017 ◽

Vol 103 (5-6) ◽

pp. 300-304

Author(s):

Shunji Endo ◽

Ryoko Hirayama ◽

Tran Van Nang ◽

Yasuyo Umeno ◽

Aiko Otani ◽

...

Keyword(s):

Medical Staff ◽

Balloon Dilatation ◽

Late Complication ◽

Esophageal Stenosis ◽

Thoracic Esophagus ◽

Gastrointestinal Series ◽

Case Presentation ◽

Corrosive Esophagitis ◽

Open Laparotomy ◽

Japanese Surgeon

Introduction: Corrosive esophagitis is often caused by the intake of alkaline or acidic substances. Esophageal stenosis is the most important late complication of corrosive esophagitis. In Laos, where Western medical care is available in few locations, treatment for esophageal stenosis is challenging. We report on a patient who was treated in Laos. Case Presentation: In Laos, an 18-year-old woman attempted to commit suicide by drinking an acidic detergent. Sixteen months later, she consulted a district hospital in Laos, which is supported by a Japanese nonprofit organization, with a chief complaint of dysphagia. An upper gastrointestinal series demonstrated severe stenosis of her thoracic esophagus. She underwent open laparotomy for gastrostomy with a urinary catheter to improve her nutritionally poor condition; the operation was performed by a Japanese surgeon with Lao medical staff. Through the gastrostomy, she injected liquid food by herself. Gradually she became unable even to drink water. Because we could not obtain any devices for esophageal dilatation in Laos, balloon dilatation catheters were donated from Japan. Twenty-three months after the injury, the endoscopic balloon dilatation for esophageal stenosis was performed by a Japanese physician, who also taught local physicians how to use the device. The patient's esophagus was as narrow as a pinhole at 20 cm from the incisors. Repeated balloon dilatation by local physicians enabled her to consume solid food orally. Conclusion: Corrosive esophagitis combined with stenosis is often difficult to treat. The Lao patient was successfully treated by a combination of local and foreign medical staff.

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