scholarly journals Esophageal caustic stenosis – difficulties of therapeutic management

2019 ◽  
Vol 6 (3) ◽  
pp. 90-95
Author(s):  
Andrei Crețu ◽  
Rodica Bîrlă ◽  
Petre Hoară ◽  
Alkadour Abdulah ◽  
Mădălina Mitrea ◽  
...  
Keyword(s):  
Life Support ◽  
Esophageal Stenosis ◽  
Oral Feeding ◽  
Middle Colic Artery ◽  
Endoscopic Dilation ◽  
Accidental Ingestion ◽  
Reconstruction Surgery ◽  
Esophageal Lumen ◽  
Caustic Injury ◽  
Caustic Stenosis

Esophageal stenosis is one of the most common sequels of caustic injury. After the ingestion, in the acute phase, the life support is sometimes critical, and the treatment varies from observation to esophagectomy. During the first 6 months, endoscopic dilation can be necessary in order to maintain the patency of the esophageal lumen. Usually, endoscopic dilation is the treatment of choice for caustic stenosis of the esophagus. Sometimes this procedure is not possible or too risky and then reconstruction surgery is needed, but no earlier than 6 months. We present the case of a 57 years old male who was referred to our clinic for the treatment of a mid-esophageal caustic stenosis, after the accidental ingestion of a concentrated alkaline substance 6 months before. After an initial successful endoscopic dilation, in the second attempt, due to the asymmetric position of the stenosis and the high risk of perforation, we decided to perform an esophageal by-pass. We chose to use the left colon for interposition, with the left branch of middle colic artery as the feeding source and the sigmoid trunk as the second arcade. The surgical procedure went uneventful, with restoration of normal oral feeding.

scholarly journals Evaluation and Management of Post-caustic Stenosis

10.37358/3700 ◽  
2019 ◽  
Vol 70 (10) ◽  
pp. 3700-3702
Keyword(s):  
Surgical Treatment ◽  
Endoscopic Treatment ◽  
Signs And Symptoms ◽  
Esophageal Stenosis ◽  
Caustic Ingestion ◽  
Upper Endoscopy ◽  
Endoscopic Dilation ◽  
Scoring Method ◽  
Caustic Stenosis

After caustic ingestion, patients may be either asymptomatic or may exhibit a variety of initial signs and symptoms, depending on the digestive segment predominantly affected. The DROOL system is a noninvasive scoring method used for the evaluation of esophageal lesions and has a good correlation with the development of esophageal stenosis. Management of these patients depends on several factors, including the presence of the symptomatology, in addition to the nature of the caustic substance. Upper endoscopy is indicated in the first 48 hours or after the first two weeks, when it is recommended to start endoscopic dilation sessions. If endoscopic treatment is inefficient, surgical treatment is required. Keywords: caustic ingestion, esophageal stenosis, esophageal bypass

scholarly journals Evaluation and Management of Post-caustic Stenosis

2019 ◽  
Vol 70 (10) ◽  
pp. 3700-3702
Author(s):  
Rodica Daniela Birla ◽  
Petre Angel Hoara ◽  
Valeriu Gabi Dinca ◽  
Silviu Constantinoiu
Keyword(s):  
Surgical Treatment ◽  
Endoscopic Treatment ◽  
Signs And Symptoms ◽  
Esophageal Stenosis ◽  
Caustic Ingestion ◽  
Upper Endoscopy ◽  
Endoscopic Dilation ◽  
Scoring Method ◽  
Caustic Stenosis

After caustic ingestion, patients may be either asymptomatic or may exhibit a variety of initial signs and symptoms, depending on the digestive segment predominantly affected. The DROOL system is a noninvasive scoring method used for the evaluation of esophageal lesions and has a good correlation with the development of esophageal stenosis. Management of these patients depends on several factors, including the presence of the symptomatology, in addition to the nature of the caustic substance. Upper endoscopy is indicated in the first 48 hours or after the first two weeks, when it is recommended to start endoscopic dilation sessions. If endoscopic treatment is inefficient, surgical treatment is required.

CAUSES OF ADVERSE SURGERY EFFECTS IN TREATMENT OF PATIENTS WITH ESOPHAGUS STENOTIC DISEASES

2020 ◽  
pp. 23-27
Author(s):  
A. Yu. Korolevska ◽  
S. Yu. Bityak ◽  
V. V. Zhidetskyi ◽  
A. B. Starikova ◽  
Ye. A. Novikov
Keyword(s):  
Postoperative Complications ◽  
Pleural Empyema ◽  
Esophageal Stenosis ◽  
Mechanical Trauma ◽  
Recurrent Nerve ◽  
Peptic Ulcers ◽  
Esophageal Lumen ◽  
Post Surgery ◽  
Tracheal Tear ◽  
Primary Trauma

Esophageal stenosis requires a responsible approach to the choice of rational treatment tactics. Intraoperatively, bleeding, interponate necrosis, complications associated with the wrong choice of the path of the interponate imposition to the neck, damage to the nutrient vessel (the arcade rupture), pleural leaves during the formation of the thoracic tunnel, n. vagus and its branches, pneumothorax, hemothorax, uncontrolled mediastinal bleeding, the need for drainage of the pleural cavity due to injury to the latter, iatrogenic splenectomy, membranous tracheal tear. Post−surgery complications are developed at different times after esophagoplasty. Most often, early postoperative complications occur because of the wound: bleeding and failure of the sutures of the anastomosis line. Complications resulted from the respiratory system are as follows: tracheobronchitis, pleurisy, "congestive", nosocomial pneumonia and atelectasis, pleural empyema. In the remote post−surgery period, the patients may experience: stenosis of the esophageal (or pharyngeal) anastomosis, adhesions, fistulas, reflux, peptic ulcers of the esophagus, pain, inflections and excess loops, complications associated with mechanical trauma of implant, scar−altered cancer esophagus, polyposis of the colon, various disorders associated with primary trauma, nonspecific complications. Damage to the recurrent nerve in patients causes constant hoarseness and difficult swallowing. Occasionally there are cardiac arrhythmias in the form of atrial fibrillation, "sympathetic" pleurisy, reflux, post−vagotomy symptom and dumping syndrome, delayed gastric emptying due to insufficient dilated pyloromyotomy in the patients with a combination of stenosis of the esophageal lumen and esophageal lumen hernia. Key words: esophageal stenosis, esophageal anastomosis, postoperative complications.

scholarly journals Modern approaches to the diagnostics and potentials of endoscopic treatment of esophageal stenoses in children

2021 ◽  
Vol 25 (4) ◽  
pp. 267-273
Author(s):  
A. O. Merkulova ◽  
A. Yu. Kharitonova ◽  
O. V. Karaseva ◽  
A. A. Shavrov
Keyword(s):  
Minimally Invasive ◽  
Clinical Picture ◽  
Scientific Literature ◽  
Balloon Dilation ◽  
Esophageal Stenosis ◽  
Cochrane Library ◽  
Common Disease ◽  
Esophageal Lumen ◽  
Literary Sources ◽  
Wide Range

Introduction. Esophageal stenosis in childhood is quite a common disease characterized by different etiology, specific clinical picture, wide range of differential diseases and a variety of approaches to its treatment.Material and methods. The review analyzes scientific literature presented in such search engines as Medline, PubMed, Cochrane Library, eLibrary, 20 years deep. The most significant works of the last century were included too. Keywords were used for search.Results. There were selected 60 literary sources which included the description of modern concepts of etiopathogenesis, classification, diagnostic and curative techniques for the treatment of esophageal stenosis in children. A particular attention is paid to the safety and effectiveness of minimally invasive endoscopic interventions (bougienage, balloon dilation) as well as to the topical application of Mitomycin C in the treatment of esophageal stenosis in children.Conclusion. Innovative endoscopic technologies applied for the restoration of the esophageal lumen seem to be promising, effective and safe. In the overwhelming majority of cases, they allow to reduce surgical aggression and avoid complex reconstructive surgeries.

scholarly journals Caustic Esophageal Stenosis: A Case Report of Endoscopic Dilation With a Dynamic Stent

2016 ◽  
Vol 23 (4) ◽  
pp. 218-223 ◽  
Author(s):  
Marlene Abreu ◽  
Isabel Nunes ◽  
Susana Corujeira ◽  
Marta Tavares ◽  
Eunice Trindade ◽  
...  
Keyword(s):  
Case Report ◽  
Esophageal Stenosis ◽  
Endoscopic Dilation

DOZ047.08: Endoscopic management of esophageal stenosis in patients with congenital esophageal atresia: experience of a single tertiary care center in Italy

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
M Deganello Saccomani ◽  
V Bortolotti ◽  
A Gastaldi ◽  
F S Camoglio ◽  
G Piacentini ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Anastomotic Stricture ◽  
Care Center ◽  
Tertiary Care ◽  
Esophageal Stenosis ◽  
Endoscopic Management ◽  
Tertiary Care Center ◽  
Endoscopic Dilation ◽  
Long Gap ◽  
Type C

Abstract Objective and Study Esophageal stenosis is the most common morbidity associated with congenital esophageal atresia (EA). There is no consensus regarding the endoscopic management of strictures in terms of timing and techniques of dilations. The aim of this study is to describe the endoscopic management of esophageal stenosis in children with EA admitted to our tertiary care center. Methods A retrospective descriptive single-center study was conducted. Data were collected of all patients diagnosed with EA admitted to the ‘Women's and Children's Hospital’ of Verona, Italy, between 2004 and 2017. Results Thirty-seven patients with EA were admitted to our center between 2004 and 2017. Twenty of them were excluded for insufficient data. All patients underwent surgical correction within 2 months of life. An endoscopic control with upper gastrointestinal endoscopy was performed in all of them. Eleven (65%) subjects had tracheoesophageal fistula. All of them had type C EA. Three (18%) had long-gap EA. Eleven patients (65%), 8 with Type C EA and 3 with Type A EA, underwent endoscopic dilation. Semirigid Savary-Giliard bougies were used in most of them. Pneumatic dilation with balloon was performed only in one case. Nine (81%) needed more than one dilation due to anastomotic stricture recurrence. In 3 of the 11 subjects (27%) more than 3 dilations were necessary. Two of them had long-gap EA. The median age of first endoscopic dilation was 3 months (range: 1–12 months). The median age of the last dilation was 6 months (range: 1–18 months). One of the 11 patients who underwent dilations (Type C EA with long gap) underwent surgical retreatment due to fistula recurrence. Six of the 17 subjects (35%) enrolled developed long-term complications. Conclusion Our data confirmed that anastomotic stricture is frequent in patients with EA who underwent surgical correction. Endoscopic management of stenosis is a safe and effective procedure that leads to a limited number of complications. Side effects are more likely to occur in patients with long-gap EA. Timing of dilations and endoscopic technique should be defined by international guidelines in order to improve patient's outcome.

Combined antegrade and retrograde esophageal endoscopic dilation for radiation-induced complete esophageal stenosis

2012 ◽  
Vol 24 (6) ◽  
pp. 483-483 ◽  
Author(s):  
Joan B Gornals ◽  
José Nogueira ◽  
Josep M. Castellvi ◽  
Jordi Guardiola
Keyword(s):  
Esophageal Stenosis ◽  
Endoscopic Dilation ◽  
Radiation Induced

scholarly journals Congenital Complete Esophageal Diaphragm: A Rare Variant of Esophageal Stenosis

2018 ◽  
Vol 7 (3) ◽  
pp. 37
Author(s):  
Nahla Kechiche ◽  
Rabeb Farhani ◽  
Badii Hmida ◽  
Rachida Lamiri ◽  
Aziza Ezzi ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Esophageal Stenosis ◽  
Endoscopic Examination ◽  
X Ray ◽  
Esophageal Lumen ◽  
Esophageal Web ◽  
Chest X Ray ◽  
Management Challenge ◽  
The Web ◽  
Endoscopic Incision

Congenital esophageal web is a rare disorder that presents a diagnostic and management challenge. In a female infant born at 31 weeks of gestation, significant secretions and respiratory distress were noted at birth. Chest X-ray demonstrated the nasogastric tube in the esogastric junction with no distal bowel gas. Esophagogram showed a congenital web near the esogastric junction. An endoscopic examination under general anesthesia showed a complete, thick membrane on the distal esophageal lumen. Endoscopic incision and cauterization of the web through the midline were performed, improving the clinical symptoms and esophageal stenosis.

scholarly journals Endoscopic Reconstruction of an Oral Feeding Route Using a Rendezvous Approach

2021 ◽  
pp. 1-6
Author(s):  
Sara Teles de Campos ◽  
Ricardo Rio-Tinto ◽  
Paulo Fidalgo ◽  
Miguel Bispo ◽  
Susana Marques ◽  
...  
Keyword(s):  
Balloon Dilation ◽  
Oral Feeding ◽  
Clinical Settings ◽  
Esophageal Obstruction ◽  
Case Presentation ◽  
Surgical Closure ◽  
Esophageal Lumen ◽  
Rendezvous Technique ◽  
Successful Case ◽  
Endoscopic Reconstruction

<b><i>Background:</i></b> The approach to esophageal obstruction or discontinuity remains challenging and often involves complex reconstructive surgeries. The rendezvous endoscopic technique might be interesting in cases of complete esophageal obstruction. <b><i>Case Presentation:</i></b> Herein we describe a successful case of endoscopic recanalization of the esophageal lumen in a patient with a long-standing esophageal discontinuity resulting from several surgeries and chemoradiation for a squamous cell carcinoma of the hypopharynx, ending in a major cervical amputation, construction of a neopharynx, and definitive surgical closure of the superior esophagus with a PEG placement. With a rendezvous technique (peroral and through the gastrostomy) and under radiographic guidance, puncture from the neopharynx into the distal esophagus was performed, followed by balloon dilation and covered metal stent placement in order to reconstruct a neoesophagus. Five weeks later, the stent was removed (using a stent-in-stent technique). No complications occurred. The patient has been able to eat soft food and is being kept under regular endoscopic surveillance to control/treat a luminal stenosis of the neoesophagus. <b><i>Conclusions:</i></b> This case report illustrates a successful endoscopic treatment of post-surgical complete esophageal obstruction. This approach should be considered in the therapeutic armamentarium of these difficult clinical settings.

scholarly journals Accidental Ingestion of 35% Hydrogen Peroxide

2007 ◽  
Vol 21 (10) ◽  
pp. 665-667 ◽  
Author(s):  
Sean Pritchett ◽  
Daniel Green ◽  
Peter Rossos
Keyword(s):  
Hydrogen Peroxide ◽  
Lipid Peroxidation ◽  
Cancer Treatment ◽  
Hiv Treatment ◽  
Oxidizing Agent ◽  
Natural Health ◽  
Accidental Ingestion ◽  
Caustic Injury ◽  
Gas Formation ◽  
Oxygen Gas

Hydrogen peroxide is a commonly used oxidizing agent with a variety of uses depending on its concentration. Ingestion of hydrogen peroxide is not an uncommon source of poisoning, and results in morbidity through three main mechanisms: direct caustic injury, oxygen gas formation and lipid peroxidation. A case of a 39-year-old man who inadvertently ingested 250 mL of unlabelled 35% hydrogen peroxide intended for natural health use is presented. Hydrogen peroxide has purported benefits ranging from HIV treatment to cancer treatment. Its use in the natural health industry represents an emerging source for accidental poisonings.

Sign in / Sign up

Export Citation Format

Share Document