Acquired Partial Nasolacrimal Obstruction due to a Suture Stent Following Esophagocolostomy

Abstract

Nasolacrimal obstruction in children is usually congenital and typically results from stenosis at the valve of Hasner. Epiphora secondary to acquired dacryostenosis is much less common. We treated a child with partial, reversible, nasolacrimal obstruction from an unusual cause, a silk suture stent used to facilitate esophageal dilation following esophagocolostomy. Report of a Case. —Esophageal atresia without tracheoesophageal fistula was diagnosed in a 5-day-old boy. A feeding gastrostomy was placed, which functioned satisfactorily until the child underwent an esophagocolostomy (interposition of a segment of colon between the pharynx and the stomach) at age 14 months. Postoperative stenosis of the neoesophagus required expansion with Tucker dilators on several occasions during the following year. For this procedure, an indwelling No. 2 silk suture was used as a guide wire stent (Fig 1); the suture passed through the nostril, nasal cavity, and nasopharynx, down through the esophagocolostomy, and exited through an external gastrostomy