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

Abstract

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.