Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. May 16, 2019; 11(5): 389-394
Published online May 16, 2019. doi: 10.4253/wjge.v11.i5.389
Post-oesophagectomy gastric conduit outlet obstruction following caustic ingestion, endoscopic management using a SX-ELLA biodegradable stent: A case report
A Musbahi, YKS Viswanath
A Musbahi, YKS Viswanath, Upper GI Laparoscopic and Endoscopic Unit, James Cook University Hospital, Middlesbrough TS43BW, Cleveland, United Kingdom
Author contributions: Musbahi A compiled case notes and wrote the first draft; Viswanath YKS contributed to editing, redrafted few times and submitted.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment
Conflict-of-interest statement: Nothing to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: YKS Viswanath, FRCS, MBBS, Professor of Surgery, Consultant, Upper GI Laparoscopic and Endoscopic Unit, James Cook University Hospital, Marton Road, Middlesbrough TS43BW, Cleveland, United Kingdom. yksviswanath@nhs.net
Telephone: +44-1642-854863 Fax: +44-1642-282872
Received: February 28, 2019
Peer-review started: March 1, 2019
First decision: April 5, 2019
Revised: April 23, 2019
Accepted: May 1, 2019
Article in press: May 1, 2019
Published online: May 16, 2019
Processing time: 78 Days and 1.3 Hours
Abstract
BACKGROUND

Benign oesophageal strictures secondary to caustic ingestion are rare and difficult to manage. They often present with symptoms such as chest pain, dysphagia and vomiting. Surgical resection is often not justified in majority of these cases who later presents with recurrent benign stricture.

CASE SUMMARY

We present a unique case of a patient who presented with post-oesophagectomy gastric conduit outlet obstruction (POGO) secondary to caustic ingestion. Our patient had already undergone two stage oesophagectomy with pyloroplasty for operable oesophageal cancer with curative intent 5 years prior. This is a distinctive case, where a successful deployment of a SX-ELLA biodegradable (BD) stent (019-10A-28/23/28-080) after failed dilatations. We have briefly reviewed literature with regards to the role BD stents in patients with recurrent benign stricture and discussed management dilemma.

CONCLUSION

We recommend the attending gastroenterologist should bear the usefulness of BD stents in the management of refractory POGO after oesophagectomy.

Keywords: : Biodegradable; Stent; Oesophagectomy; Case report

Core tip: A 69 years old, who had previous oesophagectomy, presented with weight loss, regurgitation and vomiting. He gave a history of recent caustic ingestion. Subsequent assessments revealed, delayed gastric conduit emptying with features indicative of post-oesophagectomy gastric conduit outlet obstruction (POGO). Initial conservative measures followed by 3 attempts at dilatations failed, and later endoscopically managed by deployment of SX Ella biodegradable (BD) stent across the scarred pyloric channel. He has remained symptom free and has put on weight at 8 months follow up. This is a distinctive case of utilization of BD stent in the management of post caustic pyloric stricture after previous two-stage Ivor Lewis oesophagectomy.