Caustic Esophageal Stenosis: A Case Report of Endoscopic Dilation With a Dynamic Stent

INTRODUCTION The management of esophageal strictures has evolved from surgical treatment to the endoscopic dilation and, more recently, esophageal stenting. CLINICAL CASE We describe a case of a two-year-old boy with a double stenosis of the esophagus resulting from accidental ingestion of strong alkaline liquid. After several unsuccessful endoscopic dilations for three years and even topical mitomicin, it was decided to place a dynamic stent developed by the Digestive Surgery and Endoscopic Unit of the Bambino Gesù Hospital, Rome. The stent is a custom silicon device built coaxially on a nasogastric tube that is inserted after stricture dilations, by endoscopic guidance, and then fixed outside the nose. The device was removed after seven weeks with good clinical outcome (no dysphagia more than a year of follow-up). CONCLUSION This case confirms that the dynamic stent is a simple device that may avoid aggressive surgical substitution in cases of refractory strictures.