Use of self-expanding nitinol stents in the pediatric management of refractory esophageal caustic stenosis

作者：Alonso Vernica^*; Ojha Devicka; Nalluri Harsha; Carlos de Agustin Juan

来源：Revista Espanola de Enfermedades Digestivas, 2017, 109(10): 728-730.

DOI：10.17235/reed.2017.4959/2017

• Pneumatic dilation
• Caustic ingestion
• Esophageal stenosis
• Self-expanding stents

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.

• 出版日期2017