Endoscopic Dilatation with Ultrathin Endoscope Assisted Method for Esophageal and Pyloric Stricture related Corrosive Injury: 4 Years Case Series Study
Keywords:
Corrosive injury, dilatation, esophageal, pyloric strictureAbstract
Corrosive injuries (CI) become medical problems related complications include esophageal, pyloric stricture and squamous cell carcinoma, physical and quality of life. Endoscopic (ED) dilatation is primary therapy. The ultrathin endoscope-assisted method is potentially safe and useful in avoiding technical failure. Describe clinical outcomes of ED ED-related CI including successful, refractory, recurrent, and complications-related procedures. Case series study of esophageal and/or pyloric stricture patients after CI who underwent dilatation at Soetomo General Hospital (July 2018 – July 2022). One – biweekly ED using Through The Scope (TTS) balloon or Savary Bougie dilator. The target diameter is 14mm. Fifteen patients with stricture-related CI. Eleven patients underwent ED with a total of 73 procedures. Mean age 31,45 years, predominantly male patients (6), suicide attempt (7), acid agent (9), located at esophagus (3), pylorus (3), or both (5). Number of esophageal dilatation to achieve the target of 14 mm was 1-2 and 2-15 procedures for simple and complex stricture. Five esophageal strictures were successfully dilated but 2 patients were recurrent and 3 cases were refractory to ED. Pyloric dilatation resulted in a lower success rate. Recurrent and refractory cases were 5 and 3 patients respectively. ED with ultrathin endoscope method is useful for traversing guidewire during ED. Ongoing inflammation and fibrosis were linked to recurrent and refractory stricture.References
Gautam SK, Gupta RK, Alam A. Corrosive poisoning–An update. Indian Journal of Medical Specialities. 2018;9(3). doi: 10.1016/j.injms.2018.05.012.
Joshi J. Corrosive esophageal Strictures: From dilatation to replacement: A retrospective cohort study. Dysphagia. 2020;35(4). doi: 10.1007/s00455-019- 292 10058-1.
Biswas RS, Ray D. Outcomes of the management of corrosive injuries of the upper digestive tract in a tertiary care center. Diseases of the Esophagus. 2022;35(3):295. doi: 10.1093/dote/doab096.
Kim JI. Ultrathin endoscope-assisted method for the management of upper gastrointestinal obstruction to avoid technical failure. Clin Endosc.2013;46(4):298. doi: 10.5946/ce.2013.46.4.373.
Zhang C, Zhou X, Yu L, Ding J, Shi and R. Endoscopic therapy in the treatment of caustic esophageal stricture: A retrospective case series study. Digestive Endoscopy.2013;25(5). doi: 10.1111/den.12023.
Chirica M, Bonavina L, Kelly MD, Sarfati E, Cattan P. Caustic ingestion. The Lancet. 2017;389(10083):2041-52. doi: 304 10.1016/S0140-6736(16)30313-0.
Biswas RS, Ray D. Outcomes of the management of corrosive injuries of the upper digestive tract in a tertiary care center. Diseases of the Esophagus. 2022;35(3):307. doi: 10.1093/dote/doab096.
Kochhar R. Intralesional steroid injection therapy in the management of resistant gastrointestinal strictures. World J Gastrointest Endosc. 2010;2(2):310. doi: 10.4253/wjge.v2.i2.61.
Nguyen NQ, Shah JN. Traversing difficult esophageal strictures from the oral approach. Tech Gastrointest Endosc. 2008;10(4):142–8. doi: 31310.1016/J.TGIE.2008.07.003.
Methasate A, Lohsiriwat V. Role of endoscopy in the caustic injury of the esophagus. World J Gastrointest Endosc. 2018;10(10). doi: 10.4253/wjge.v10.i10.274.
Mulcahy HE, Fairclough PD. Ultrathin video endoscopy is valuable in the initial assessment and treatment of upper and lower gastrointestinal strictures. Gastrointest Endosc. 1998;47(4).
Andreevski V. Four-year results of conservative treatment of benign strictures of the esophagus with savary gilliard technique of bougienage: cross-sectional study representing first experiences in republic of macedonia. Prilozi. 2018;39(1):322. doi: 10.2478/prilozi-2018-0021.
Tharavej C, Pungpapong S, Chanswangphuvana P. Outcome of dilatation and predictors of failed dilatation in patients with acid-induced corrosive esophageal strictures. Surg Endosc. 2018;32(2):325. doi: 10.1007/s00464-017-5764-x.
Fugazza A, Repici A. Endoscopic management of refractory benign esophageal strictures. Dysphagia. 2021;36(3):504–16. doi: 328 10.1007/s00455-021-10270-y.
Kochman ML, McClave SA, Boyce HW. The refractory and the recurrent esophageal stricture: A definition. Gastrointestinal Endoscopy2005;62(3):331. doi: 10.1016/j.gie.2005.04.050.
Elkaramany M. An overview of corrosive injury of the upper gastrointestinal tract: Discussion of types, clinical evaluation, and management procedures. Advances in Digestive Medicine. 2018;5(4). doi: 10.1002/aid2.13091.
Contini S, Scarpignato C. Caustic injury of the upper gastrointestinal tract: A comprehensive review. World J Gastroenterol. 2013;19(25). doi: 33710.3748/wjg.v19.i25.3918.
Boregowda U. Endoscopic management of benign recalcitrant esophageal strictures. Annals of Gastroenterology. 2021;34(3). doi: 34010.20524/aog.2021.0585.
Sami S. UK guidelines on oesophageal dilatation in clinical practice. Gut. 2018; 342(67):6. doi: 10.1136/gutjnl-2017-315414.
Singhal S, Hasan SS, Cohen DC, Pfanner T, Reznik S, Duddempudi S. Multi-disciplinary approach for management of refractory benign occlusive esophageal stricture. Therap Adv Gastroenterol. 2013;6(5). doi: 346 10.1177/1756283X13492000.
Josino IR. Endoscopic dilation with bougies versus balloon dilation in esophageal benign strictures: Systematic review and meta-analysis. Gastroenterol Res Pract. 2018;349. doi: 10.1155/2018/5874870.
Lahoti D, Broor SL. Corrosive injury to the upper gastrointestinal tract. Indian Journal of Gastroenterology: official journal of the Indian Society of Gastroenterology. 1993;352(12):4.
Downloads
Published
How to Cite
Issue
Section
License
CopyrightThe authors who publish this journal agree to the following requirements:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. (See The Effect of Open Access)
The names and email addresses entered in this journal site will be used exclusively for the stated purposes of this journal and will not be made available for any other purpose or to any other party.
