A case of esophageal stricture after corrosive esophagitis successfully treated by frequent endoscopic balloon dilation

Abstract

A 14-year-old girl was admitted to our hospital for treatment of abdominal pain after an attempt to commit suicide by swallowing a caustic soda solution. Severe esophageal stricture following corrosive esophagitis occurred 2 weeks after admission. First, we tried to dilate the stenotic esophagus by using an esophageal bougie, but it was not effective and was also painful, and the treatment was stopped. Next, we tried endoscopic balloon dilation. This procedure was less painful and more effective for dilating the stenotic esophagus than was the bougie. At first, we used a pneumatic balloon and injected a steroid locally under the mucosal layer after dilation. The same procedure was continued in the outpatient clinic, but each interval of the procedures, about 3 weeks, was not changed for about 1 year. After 1 year of consecutive trials of frequent dilatation using a pneumatic balloon, the type of balloon was changed to a hydrostatic type. Three months after changing the type of balloon, treatment with tranilast, which was expected to be effective for prevention of restenosis, was started instead of steroid injection to the stenotic portion. After starting tranilast treatment, the interval of dilation became longer and the stricture itself gradually became dilated. Twentyone months later, the interval of dilation was 3-4 months and oral intake had improved greatly. We therefore concluded that frequent endoscopic balloon dilation is effective for dilating stenosis after corrosive esophagitis. In addition, this case suggests that treatment with tranilast could be effective for preventing esophageal restenosis after balloon dilation.

In situ gelation properties of a collagen–genipin sol with a potential for the treatment of gastrointestinal ulcers

“…Treatments for procedural accidents are generally symptomatic and include coagulation of bleeding vessels using hemostatic forceps and immediate closure of acute perforations using endoclips 5. Artificial ulcers are the major cause of complications of endoscopic therapy and occasionally cause gastrointestinal strictures that require treatment with endoscopic balloon dilatation and stent placement,6,7 which also carry risks of acute perforation 8. Hence, because intractable ulcers can progress to delayed perforations,9 prophylactic treatments for procedural accidents and complications are urgently required.…”

Severe long esophageal stricture following hyperemesis gravidarum

“…Benign esophageal strictures are caused by gastroesophageal reflux disease (GERD), ingestion of corrosives, cytomegalovirus infection, Crohn's disease, and other factors [1][2][3][4]. There have been several reports regarding esophageal stricture accompanying pregnancy since the report by Vinson in 1921 (Table 1) [5][6][7][8][9][10][11][12][13].…”