Esophageal replacement using a reversed gastric tube for lye stricture in a child: report of a case

Area of Science:

• Pediatric Gastroenterology
• Surgical Innovation
• Toxic Ingestion Management

Background:

• Corrosive esophagitis, often caused by ingesting alkaline substances like lye, can lead to severe esophageal strictures.
• Endoscopic interventions such as balloon dilatation are common treatments for esophageal stenosis.
• Complications like esophageal perforation can arise during or after such procedures.

Observation:

• A 5-year-old girl presented with esophageal stenosis and mediastinitis following balloon dilatation for lye-induced corrosive esophagitis.
• Initial conservative management successfully treated the mediastinitis but did not resolve the esophageal stenosis.
• The patient underwent esophageal replacement surgery due to persistent obstruction.

Findings:

• Esophageal replacement using a reversed gastric tube effectively relieved the esophageal obstruction.
• The patient experienced mild gastroesophageal reflux six months after the surgery.
• This case highlights the challenges in managing severe corrosive esophagitis and its complications.

Implications:

• Reversed gastric tube esophagoplasty is a viable option for treating complex esophageal strictures unresponsive to conservative measures.
• Careful monitoring for complications like perforation and long-term sequelae such as reflux is crucial after corrosive esophageal injury.
• This approach offers a solution for pediatric patients with severe esophageal damage from chemical ingestion.