An Intractable Caustic Esophageal Stricture Successfully Managed with Sequential Treatment Comprising Incision with an Insulated-Tip Knife, Balloon Dilation, and an Oral Steroid
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Bougie or balloon dilation is a good short-term treatment for caustic esophageal strictures, although recurrence after dilation occurs inapproximately 30% of these cases. Therefore, long-term treatment options are required in some cases, and endoscopic incisional therapyhas been used for patients with an anastomotic stricture in the gastrointestinal tract. A 58-year-old woman presented with severeswallowing diffculty because of a caustic esophageal stricture, which was caused by accidental exposure to anhydrous acetic acid atinfancy. She had undergone several previous bougie and balloon dilations but the stricture did not improve. We performed sequentialtreatment comprising incision with an insulated-tip knife, balloon dilation, and an oral steroid, which resulted in the patient’s symptomsmarkedly improving. Thus, we report this case of an intractable caustic esophageal stricture, which was successfully treated usingcombined endoscopic sequential treatment.
Abstract
Bougie or balloon dilation is a good short-term treatment for caustic esophageal strictures, although recurrence after dilation occurs inapproximately 30% of these cases. Therefore, long-term treatment options are required in some cases, and endoscopic incisional therapyhas been used for patients with an anastomotic stricture in the gastrointestinal tract. A 58-year-old woman presented with severeswallowing diffculty because of a caustic esophageal stricture, which was caused by accidental exposure to anhydrous acetic acid atinfancy. She had undergone several previous bougie and balloon dilations but the stricture did not improve. We performed sequentialtreatment comprising incision with an insulated-tip knife, balloon dilation, and an oral steroid, which resulted in the patient’s symptomsmarkedly improving. Thus, we report this case of an intractable caustic esophageal stricture, which was successfully treated usingcombined endoscopic sequential treatment.
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