Endoscopic dilatation for caustic esophageal strictures

ABSTRACT

To determine the outcome of esophageal dilatation in caustic esophageal strictures in our Patients. This descriptive study was conducted in the department of Gastroenterology and Hepatology Hayatabad medical complex from 1999 to 2007. Patients with caustic esophageal strictures and above 03 years of age were included. Patient with caustic stricture and fistulae or diverticulae, peptic stricture and malignant stricture were excluded. Patients were initially evaluated with barium swallow and meal. Consenting patient were asked to come in the morning after over night fasting. Guide wire was positioned across the strictures with the help of the endoscope [GIF-140/GIF-N130]. SavouryGilliard plastic dilators of increasing sizing were employed. Repeated sessions were performed fortnightly till a 15mm [45Fr] lumen size was achieved. Follow up session were arranged whenever dysphagia developed. Out of 20 patients, 11 patients [55%] were more than 12 years of age. Mean age is 19.25 ranging from 3 years to 65 years. There were ten males [50%] and ten females [50%]. Total dilatations were 442. Successful dilatation up to a lumen size of 15mm could be achieved in twelve patients [60%]. In six patients [30%] satisfactory dilatation could not be achieved and were referred for surgery. Two patients [10%] had perforation with an incidence rate of 0.45%. Caustic Stricture is more common in adolescent and adults in our population. Endoscopic dilatation is modestly effective in achieving adequate dilatation and relieving dysphagia