ENDOSCOPIC TREATMENT OF CAUSTIC STENOSIS: ABOUT 42 CASES

Aims Ingestion of a corrosive substance causes esophageal lesions of varying severity. The endoscopic assessment allows to make the inventory of digestive lesions that condition the prognosis and guide the therapeutic strategy. Treatment of esophageal stenosis, once organized, involves endoscopic treatment (dilatation) and/or surgery. Our work aimed to report, through a retrospective analysis, the experience of our department concerning the endoscopic treatment of caustic stenosis.

Methods It was a 24-year study conducted between 1995 and 2019 at the level of our Department of Digestive Diseases. During this period 42 patients with esophageal stenosis caused by caustic ingestion were registered. The treatment consisted in providing a dilatation using the bougies of Savary-Gilliard.

Results Forty-two cases were enrolled during the study period, or 7.2% of 577 patients followed for esophageal stenosis of different etiology. The median age of patients was 36 years with a male predominance and a sex ratio (H/F) of 1.8. Hydrochloric acid was implicated in 67% of cases, followed by bleach by 14% and potash by 7%. In our practice, the endoscopic treatment of caustic stenoses consisted in the use of Savary-Gilliard candles. The median number of dilatation sessions was 2.6. The most commonly used bougie diameters were the diameters 12 and 14. The evolution after one dilatation was favorable in 47% and required more than one dilatation session in 53%. The average time of relapse after an endoscopic treatment was one month. No complications were recorded.

Conclusions Caustic stenosis remains a benign condition in the majority of cases, however, it may have consequences with an esophageal stenosis witch remains a long and difficult condition to treat. Repeated endoscopic dilatation remains a treatment with little morbidity that can delay surgery.