A case of esophageal stricture due to burn injury successfully treated by endoscopic dilatation with steroid injection

Abstract

A 22-year-old male sufferd upper aerodigestive tract burn by an unexpected explosion of firework in his mouth. A month later, esophageal stricture developed and needed weekly endoscopic dilatation. 7 months later, he was introduced to our hospital for treatment of his esophageal stricture. He could not swallow down meat and fish. Endoscopic examination revealed esophageal stenosis through 18cm to 22cm from incisor, and a narrow diameter endoscope (8mm in diameter) could not pass through the stenotic lesion. After treatment with a balloon dilator (12mm in diameter) , a panendoscope (11mm in diameter) could pass through the stenotic lesion. Then, he underwent a balloon dilatation every two weeks. However, after a few days following dilatation, esophageal stricture developed again. Then, we tried endoscopic steroid injection three months following the first treatment. Approximately 2mg of dexamethasone was injected into stenotic site in four directions. After three courses of steroid injection therapy, a panendoscope could pass through the stenotic lesion with ease, and he could swallow meat and fish.