1. Use of self-expanding nitinol stents in the pediatric management of refractory esophageal caustic stenosis
- Author
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Verónica Alonso, Devicka Ojha, Harsha Nalluri, and Juan Carlos de-Agustín
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Pneumatic dilation ,Caustic ingestion ,Esophageal stenosis ,Self-expanding stents ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
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.
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