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

Abstract

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.