Abreu Marlene, Nunes Isabel, Corujeira Susana, Tavares Marta, Trindade Eunice, Dias Jorge Amil
Unit of Pediatric Gastroenterology, Centro Hospitalar de São João, Porto, Portugal.
GE Port J Gastroenterol. 2016 Feb 19;23(4):218-223. doi: 10.1016/j.jpge.2015.12.006. eCollection 2016 Jul-Aug.
The management of esophageal strictures has evolved from surgical treatment to the endoscopic dilation and, more recently, esophageal stenting.
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).
This case confirms that the dynamic stent is a simple device that may avoid aggressive surgical substitution in cases of refractory strictures.
食管狭窄的治疗方法已从外科手术发展到内镜扩张，最近又出现了食管支架置入术。
我们描述了一名两岁男孩的病例，他因意外摄入强碱性液体导致食管双重狭窄。在历经三年多次内镜扩张甚至局部使用丝裂霉素均未成功后，决定置入由罗马 Bambino Gesù 医院消化外科和内镜科研发的动态支架。该支架是一种定制的硅制装置，同轴安装在一根鼻胃管上，在狭窄扩张后通过内镜引导插入，然后固定在鼻外。七周后取出该装置，临床效果良好（随访一年以上无吞咽困难）。
该病例证实，动态支架是一种简单的装置，在难治性狭窄病例中可避免激进的手术替代。
