Published online Apr 28, 2014. doi: 10.3748/wjg.v20.i16.4806
Revised: February 20, 2014
Accepted: March 7, 2014
Published online: April 28, 2014
This report presents the case of an 8.5-year-old boy with Down syndrome after experiencing extensive caustic injury to the oesophagus and stomach resulting from the accidental ingestion of concentrated sulphuric acid. The patient had undergone 32 unsuccessful endoscopic oesophageal stricture dilatations and stenting procedures performed over a period of 15 mo following the accident. Surgical reconstruction of the oesophagus was not possible due to previous gastric and cardiac surgeries for congenital conditions. Before referring the patient for salivary fistula surgery, the patient received a nasogastric tube with perforations located above the upper margin of the oesophageal stenosis for the passage of saliva and fluid. The tube was well tolerated and improved swallowing; however the backflow of gastric contents caused recurrent infections of the respiratory tract. To overcome these problems, we developed a double lumen, varying diameter, perforated tube for protection of the oesophageal closure. This nasogastric tube was found to be safe and decreased the need for hospitalization and further endoscopic procedures. This newly developed tube can thus be considered as a treatment option for patients with recurrent oesophageal stenosis and contraindications for surgical oesophageal reconstruction.
Core tip: This report presents the design and use of a perforated nasogastric tube for passage of saliva and fluids in a paediatric patient who was unsuitable for oesophageal reconstructive surgery. The perforated tube was safe, well tolerated and reduced the need for hospitalization and endoscopic oesophageal dilatation. Therefore, this newly developed perforated nasogastric tube can be used as an alternative method for corrosive oesophageal stenosis therapy in patients who cannot undergo reconstructive surgery.