scholarly journals Stent Flange-Induced Esophageal Stricture Treated with an Oral Steroid

2021 ◽  
Vol 96 (4) ◽  
pp. 352-355
Author(s):  
Junyoung Seo ◽  
Ju Sang Park
Keyword(s):  
Esophageal Stricture ◽  
Anastomotic Stricture ◽  
Balloon Dilation ◽  
Oral Steroid ◽  
Metallic Stent ◽  
Endoscopic Balloon Dilation ◽  
Stent Removal ◽  
First Case ◽  
Covered Metallic Stent ◽  
Endoscopic Balloon

Esophageal stent complications include stent migration, tumor ingrowth, perforation, a broncho-esophageal fistula, and gastroesophageal reflux. Development of a new stricture at a flange site after stent removal has been predicted but not yet reported. We experienced the first case of a recurrent esophageal stricture induced by a stent flange after stent removal. A fully covered metallic stent, which had been inserted 2 months ago for treatment of an anastomotic stricture, triggered another stricture at the flange site. Although endoscopic balloon dilatations were repeated several times and then the 2nd stent for rescue therapy was inserted, the stricture was refractory to all treatment. Thus, we prescribed oral prednisolone with repeated endoscopic balloon dilation; the stricture eventually improved. The oral steroid seemed to suppress stricture development. If a stent flange-induced refractory stricture is encountered, an oral steroid combined with endoscopic balloon dilation may be helpful.

scholarly journals Endoscopic submucosal dissection to relieve a flexure of the gastric conduit after esophagectomy

2018 ◽  
Vol 06 (03) ◽  
pp. E350-E353
Author(s):  
Katsumi Yamamoto ◽  
Hiroshi Noro ◽  
Yu Sato ◽  
Akira Kusakabe ◽  
Nobuyuki Tatsumi ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Balloon Dilation ◽  
Endoscopic Examination ◽  
Gastric Conduit ◽  
Endoscopic Balloon Dilation ◽  
Effective Treatment Option ◽  
Submucosal Dissection ◽  
First Case ◽  
Posterior Mediastinal ◽  
Endoscopic Balloon

Abstract Background and study aims A 70-year-old-man underwent an esophagectomy and posterior mediastinal reconstruction for esophageal cancer that was curatively resected. Although the patient was allowed to eat after surgery, he repeatedly vomited after drinking water or eating meals and required continuous hospitalization. An upper gastrointestinal series and endoscopic examination revealed an obstruction due to the flexure of the gastric conduit, which was repeatedly treated with endoscopic balloon dilation. Endoscopic balloon dilation was completely ineffective, however, because the obstruction was not due to a small lumen diameter, but rather to severe flexure. We hypothesized that the power of contraction provided by ulcer scar formation after mucosal resection could straighten the flexure, and thus removed a piece of the mucosa 8 cm in diameter on the oral side of the flexure by endoscopic submucosal dissection (ESD) 4 months after the esophagectomy. Endoscopic examination on post-ESD Day 10 revealed that the gastric conduit flexure was straightened due to ulcer scarring, and obstruction at the flexure opened over time. Meals were restarted and the patient could eat without vomiting. He was discharged from the hospital 5 weeks after ESD. This is the first case report of obstruction due to flexure of the gastric conduit after esophagectomy that was successfully treated with mucosectomy using ESD. Mucosectomy using ESD may be an effective treatment option for obstruction due to flexure of the gastric conduit after esophagectomy.

scholarly journals Roles of Steroids in Preventing Esophageal Stricture after Endoscopic Resection

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Yu Qiu ◽  
Ruihua Shi
Keyword(s):  
Endoscopic Resection ◽  
Esophageal Stricture ◽  
Steroid Injection ◽  
Relevant Literature ◽  
Balloon Dilation ◽  
Oral Steroid ◽  
Stricture Formation ◽  
Steroid Administration ◽  
Local Steroid Injection ◽  
Endoscopic Balloon

Background and Purposes. Endoscopic resection has been worldwide recognized as a treatment strategy for early esophageal lesions. The occurrence of esophageal stricture after endoscopic resection will reduce the quality of life of patients. This study will evaluate the efficacy and safety of steroids in the prevention of esophageal stricture after endoscopic resection and the influence of different steroid administration methods.Methods. In the relevant literature database, literature from 2008 to 2018 is retrieved by using preset keywords, the search results are carefully screened, and the conclusion of the literature is synthesized to form arguments and draw conclusions.Results. 73 articles met our requirements. Oral steroid administration, not prophylactic endoscopic balloon dilation alone, was effective in preventing esophagostenosis after esophagoscopic treatment and reducing the number of repeated endoscopic balloon dilations even after extensive endoscopic resection. Local steroid injection is useful and economy for preventing esophageal stricture, even though it may raise the risk of perforation during dilations. A wider range of circumferential mucosal defects is an independent predictor for stricture formation for patents given preventive steroid injections after endoscopic submucosal dissection. For complete circular mucosal defect, the further researches are essential to investigate the role of local steroid injection. The effect of other methods such as steroid gel, intravenous infusion of steroid, and novel steroid filling methods require more confirmation.Conclusions. Therefore, steroids play an irreplaceable role in preventing esophageal stricture after endoscopic resection. Oral and local injections of steroids are the two most acceptable methods and more prospective studies are needed to compare the effectiveness and safety of these two methods.

scholarly journals A case of a rectal stricture related to ischemic proctitis following rupture of an aortic aneurysm

2018 ◽  
Vol 06 (02) ◽  
pp. E186-E189
Author(s):  
Tomoya Iida ◽  
Yosuke Ohkubo ◽  
Toshiyuki Kubo ◽  
Kentaro Yamashita ◽  
Kei Onodera ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Ischemic Colitis ◽  
Aortic Rupture ◽  
Balloon Dilation ◽  
Rectal Stricture ◽  
Endoscopic Balloon Dilation ◽  
First Case ◽  
Abdominal Aortic ◽  
Ischemic Proctitis ◽  
Endoscopic Balloon

Abstract Background and study aims Ischemic proctitis is a rare disease and comprises 2 % to 5 % of cases of ischemic colitis, because the rectum has abundant blood supply and rich collaterals. Herein, we report a case of a 73-year-old male patient with a pronounced rectal stricture caused by ischemic proctitis resulting from an abdominal aortic rupture and treated by endoscopic balloon dilation therapy. To date, only 3 cases of rectal stricture related to ischemic proctitis including our case have been reported, and this is the first case of rectal stricture related to ischemic proctitis, which was successfully treated by endoscopic balloon dilation.

A case of esophageal stricture after corrosive esophagitis successfully treated by frequent endoscopic balloon dilation

Esophagus ◽  
2004 ◽  
Vol 1 (4) ◽  
pp. 193-197 ◽  
Author(s):  
Tomokazu Matsuyama ◽  
Satoshi Aiko ◽  
Yutaka Yoshizumi ◽  
Yoshiaki Sugiura ◽  
Tadaaki Maehara
Keyword(s):  
Esophageal Stricture ◽  
Balloon Dilation ◽  
Endoscopic Balloon Dilation ◽  
Corrosive Esophagitis ◽  
Endoscopic Balloon
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