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Corresponding author at: Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, 776, 1 Sunhwan-ro, Seowon-gu, Cheongju 28644, South Korea.
A 69-year-old man presented with dysphagia after drinking a little water. Two weeks
earlier, he had visited the emergency department with a sore throat and shortness
of breath after ingesting lye 2 hours prior. Emergency esophagogastroduodenoscopy
and chest computed tomography revealed high-grade injury throughout most of the oropharynx
(Fig. 1A and B) and esophagus (Fig. 1C and D). He was hospitalized and managed conservatively and received broad-spectrum
antibiotics intravenously. At his current presentation, esophagogastroduodenoscopy
and esophagography revealed a severe mid-esophageal stricture (Fig. 2A and B). To avoid surgery or difficult endoscopic procedure due to complete esophageal
obstruction [
Esophageal luminal restoration for a patient with a long lye-induced stricture via
tunnel endoscopic therapy during a rendezvous procedure followed by self-dilation
(with video).
], fluoroscopy guided esophagogastroduodenoscopy was performed, and a 12cm fully covered
esophageal self-expanding metal stent (Hanarostent®, M.I. Tech, Co., Ltd., Korea)
was successfully inserted; a long-segment esophageal stricture was confirmed (Fig. 2C and D). The patient's clinical condition gradually improved, and he was discharged
on the seventh day after intervention. The esophageal stent was removed at his 3-month
follow-up. Since then, esophageal balloon dilation is repeated each time the patient
presents with dysphagia secondary to the development of recurrent esophageal stricture.
Fig. 1Initial esophagogastroduodenoscopy shows a mucosal edema and hyperemia on base of
tongue (A), and a diffuse extensive necrosis throughout most of the esophagus (C).
Also, initial neck and chest computed tomography show an enhancing wall thickening
at the pharynx (B) and esophagus (D).
Fig. 2Esophagogastroduodenoscopy and esophagography show a marked mid-esophageal stricture
(A and B). Fluoroscopy guided esophagogastroduodenoscopy shows inserted 12cm fully
covered self-expanding metal stent for a severe long-segment esophageal stricture
(C and D).
Esophageal luminal restoration for a patient with a long lye-induced stricture via tunnel endoscopic therapy during a rendezvous procedure followed by self-dilation (with video).
