Fang JH, Li WM, He CH, Wu JL, Guo Y, Lai ZC, Li GD. Endoscopic treatment of extreme esophageal stenosis complicated with esophagotracheal fistula: A case report. World J Gastrointest Surg 2024; 16(1): 239-247 [PMID: 38328322 DOI: 10.4240/wjgs.v16.i1.239]
Corresponding Author of This Article
Guo-Dong Li, MD, Doctor, Department of Gastroenterology, Hangzhou Normal University Affiliated Hospital, No. 126 Wenzhou Road, Hangzhou 310000, Zhejiang Province, China. ligd_hzsffsyy@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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/
Jia-Heng Fang, Wei-Min Li, Cheng-Hai He, Jian-Liang Wu, Yun Guo, Zhi-Chao Lai, Guo-Dong Li, Department of Gastroenterology, Hangzhou Normal University Affiliated Hospital, Hangzhou 310000, Zhejiang Province, China
Author contributions: Li GD performed all surgical treatments; Fang JH prepared the initial draft of the manuscript and revised the manuscript; Li GD and Wu JL critically reviewed and revised the manuscript and provided input on the endoscopic operation aspects of the manuscript; Guo Y, Lai ZC, Li WM, and He CH contributed equally toward the senior authorship of this manuscript; all authors contributed to the article and approved the submitted version.
Informed consent statement: The study was reviewed and approved by Hangzhou Normal University Affiliated Hospital’s ethics committee. The patient provided written informed consent for the publication of this case report.
Conflict-of-interest statement: There is no conflict of interest 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 that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guo-Dong Li, MD, Doctor, Department of Gastroenterology, Hangzhou Normal University Affiliated Hospital, No. 126 Wenzhou Road, Hangzhou 310000, Zhejiang Province, China. ligd_hzsffsyy@163.com
Received: October 15, 2023 Peer-review started: October 15, 2023 First decision: November 16, 2023 Revised: November 25, 2023 Accepted: December 12, 2023 Article in press: December 12, 2023 Published online: January 27, 2024 Processing time: 102 Days and 0.5 Hours
Abstract
BACKGROUND
At present, there is no unified and effective treatment for extreme corrosive esophageal stenosis (CES) with esophagotracheal fistula (ETF). This case had extreme and severe esophageal stenosis (ES) and ETF after ingesting an enzyme-based chemical detergent, resulting in a serious pulmonary infection and severe malnutrition. Upper gastrointestinal imaging showed that he had an ETF, and endoscopy showed that he had extreme and severe esophageal stricture. This case was complex and difficult to treat. According to the domestic and foreign literature, there is no universal treatment that is low-risk.
CASE SUMMARY
A patient came to our hospital with extreme ES, an ETF, and severe malnutrition complicated with pulmonary tuberculosis 1 mo after the consumption of an enzyme-based detergent. The ES was serious, and the endoscope was unable to pass through the esophagus. We treated him by endoscopic incision method (EIM), esophageal stent placement (ESP), and endoscopic balloon dilation (EBD) by using the bronchoscope and gastroscope. This treatment not only closed the ETF, but also expanded the esophagus, with minimal trauma, greatly reducing the pain of the patient. According to the literature, there are no similar reported cases.
CONCLUSION
We report, for the first time, a patient with extreme CES complicated with ETF, where the endoscope could not be passed through his esophagus but he could be examined by bronchoscopy and treated by EIM, ESP, and EBD.
Core Tip: Patients who have extreme corrosive esophageal stenosis (CES) with esophagotracheal fistula (ETF) often suffer a lot and have bad quality of their lives. Currently, there are no clinical evidence-based guidelines, and there is great uncertainty regarding the best treatment approach. We report, for the first time, a patient with extreme CES complicated with ETF, where the endoscope could not be passed through his esophagus but he could be examined by bronchoscopy and treated by endoscopic incision method, esophageal stent placement, and endoscopic balloon dilation.
