Year 2023 / Volume 115 / Number 4
Letter
Refractory benign esophageal strictures – Cut or dilate?

206-207

DOI: 10.17235/reed.2022.9153/2022

Muhammad Ismail, Carlos Noronha Ferreira, Miguel Moura, Luís Carrilho Ribeiro, Rui Tato Marinho,

Abstract
A 67-year-old male patient with long term gastroesophageal reflux disease (GERD) on double dose proton pump inhibitors, presented with dysphagia for soft foods. He underwent upper gastrointestinal (UGI) endoscopy which revealed a severe regular stricture at the level of the esophagogastric junction with a residual luminal orifice measuring 2 mm. Biopsies at the site of the stricture ruled out malignancy and were suggestive of peptic etiology. The patient underwent twelve endoscopic dilatation sessions, 11 of them with Savary-Guillard bougies and 1 with TTS balloon, up to a maximal diameter of 18 mm, with only partial relief of dysphagia symptoms. Due to the persistence of the stricture and dysphagia symptoms, incisional therapy was performed in two endoscopic sessions at the site of the stricture was performed with a Mori´s knife parallel to the longitudinal axis of the esophagus in a radial manner in all of the quadrants. There were no adverse events. On follow-up, 2 months later after the last session, the patient had a significant improvement and did not have any dysphagia symptoms. UGI endoscopy revealed minimal residual narrowing at the site of the previous stricture in the distal esophagus. He remains asymptomatic after 6 months follow-up.
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References
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3. Samanta J. Endoscopic incisional therapy for benign esophageal strictures: Technique and results. World J Gastrointest Endosc. 2015;7(19):1318.
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Ismail M, Ferreira C, Moura M, Ribeiro L, Marinho R. Refractory benign esophageal strictures – Cut or dilate?. 9153/2022


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Publication history

Received: 24/08/2022

Accepted: 27/08/2022

Online First: 12/09/2022

Published: 03/04/2023

Article Online First time: 19 days

Article editing time: 222 days


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