Abstract

ALONSO, Verónica; OJHA, Devicka; NALLURI, Harsha  and  DE-AGUSTIN, Juan Carlos. Use of self-expanding nitinol stents in the pediatric management of refractory esophageal caustic stenosis. Rev. esp. enferm. dig. [online]. 2017, vol.109, n.10, pp.728-730. ISSN 1130-0108.  https://dx.doi.org/10.17235/reed.2017.4959/2017.

Background: The treatment of recurrent esophageal stricture secondary to the ingestion of a caustic agent is an arduous task. Self-expanding esophageal stents may be an alternative to repeated endoscopic esophageal dilations. Case report: We present the case of a two-year-old male with a severe and long esophageal stricture successfully treated by the combination of dilations and stent placement. After five months of serial pneumatic dilations, three self-expanding nitinol stents internally coated with silicone were introduced through a gastrostomy, covering the entire esophagus. The procedure was performed under endoscopic and radiological guidance. Three months later, the treatment was repeated with a single stent. A new stenosis in the proximal esophagus required surgical resection, and anastomosis followed by two pneumatic dilations for five months resulted in longer intervals where the patient was asymptomatic. Discussion: The results obtained were satisfactory, allowing the patient to conserve and use his own esophagus. However, this is a unique case and the optimal maintenance time and withdrawal time of the stent must be determined.

Keywords : Pneumatic dilation; Caustic ingestion; Esophageal stenosis; Self-expanding stents.

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