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Refractory benign esophageal strictures - Cut or dilate?
Muhammad Ismail1, Carlos Noronha Ferreira2, Miguel Moura2
1Gastroenterology, Hospital Central de Maputo, Mozambique.
Revista Espanola De Enfermedades Digestivas
|September 12, 2022
Summary
A patient with severe GERD-related esophageal stricture experienced persistent dysphagia despite multiple dilations. Incisional therapy provided significant symptom relief and improved esophageal patency.
Area of Science:
- Gastroenterology
- Gastrointestinal Endoscopy
Background:
- Gastroesophageal reflux disease (GERD) can lead to peptic strictures, causing dysphagia.
- Refractory esophageal strictures pose a therapeutic challenge, often requiring multiple interventions.
Observation:
- A 67-year-old male with long-standing GERD presented with severe dysphagia due to a 2 mm esophagogastric junction stricture.
- Initial treatment with twelve endoscopic dilations yielded only partial symptom relief.
Findings:
- Endoscopic incisional therapy using a Mori's knife was performed in two sessions.
- The procedure resulted in significant improvement in dysphagia symptoms and minimal residual narrowing on follow-up endoscopy.
Implications:
- Endoscopic incisional therapy is a viable option for managing refractory peptic esophageal strictures.
- This technique offers a minimally invasive approach to improve luminal patency and alleviate dysphagia.
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