A case of benign esophageal stricture of unknown origin

Abstract

A 57-year-old male was admitted to our hospital complaining of slowly progressing dysphagia. Upper gastrointestinal endoscopy visualized stricture of the in the lower esophagus, and barium study documented smooth narrowing of the lower esophagus. Biopsy specimens taken from the narrowed segment failed to reveal any evidence of malignancy. He was diagnosed as having idiopathic benign esophageal stricture. The initial balloon dilatation succeeded to improve the narrowing of the esophagus, but he developed dysphagia again 2 months later. Repeated balloon dilatations were unsuccessful. Finally, he agreed to have operation done, and wall thickening of the lower esophagus was noted in the resected specimen. Histologically, marked fibrosis in the submucosal layer was only seen.
Benign esophageal stricture is known to be induced by infectious, chemical, physical and other factors. There have been several reports on benign esophageal stricture probably due to submucosal dissection with sudden onset of retrosternal pain. In our case, however, etiology may be different from submucosal dissection because of no episode of retrosternal pain and slowly progressing dysphagia. Surgical resection of the esophagus was performed in this case, but the best suited treatment of this pathological condition is awaiting to be solved.