Empleo de stents autoexpandibles de nitinol en el manejo pediátrico de la estenosis cáustica esofágica refractaria
- Verónica Alonso
- Devicka Ojha
- Harsha Nalluri
- Juan Carlos de Agustín Asensio
ISSN: 2340-416, 1130-0108
Year of publication: 2017
Volume: 109
Issue: 10
Pages: 728-730
Type: Article
More publications in: Revista Española de Enfermedades Digestivas
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.