Intralesional steroids in refractory caustic esophageal stricture

Area of Science:

• Pediatric Gastroenterology
• Otolaryngology
• Surgical Research

Background:

• Caustic esophageal strictures are a severe complication of ingestion injuries, often requiring multiple dilations.
• Refractory cases pose a significant challenge, necessitating novel treatment approaches.

Purpose of the Study:

• To evaluate the efficacy of intralesional steroid (triamcinolone acetonide) treatment for refractory caustic esophageal strictures in pediatric patients.
• To analyze the impact of this treatment on stricture characteristics and dilation requirements.

Main Methods:

• A retrospective analytical study was conducted on pediatric patients with refractory caustic esophageal strictures treated with intralesional triamcinolone acetonide.
• Data collected included patient demographics, stricture details, and pre- and post-treatment dilation scores.
• Statistical analysis (T-Test, Wilcoxon test) was used to compare outcomes.

Main Results:

• Treatment with intralesional steroids led to a significant decrease in esophageal stricture length (3.60 cm, p=0.019).
• The dilation score, representing dilations per month, significantly reduced from 1.47 to 0.47 (p=0.043).
• No significant change was observed in stricture diameter.

Conclusions:

• Intralesional triamcinolone acetonide appears to be a beneficial treatment for refractory caustic esophageal strictures in children.
• The therapy effectively reduces stricture length and the frequency of dilations, offering a potential improvement in management.
• Further research is warranted due to limited data in the pediatric population.