Mitomycin C in the management of pediatric caustic esophageal strictures: a case report.
Although the incidence of caustic ingestion is declining, the management of caustic esophageal strictures remains a challenge. Mitomycin C (MMC) inhibits fibroblast proliferation and is effective in reducing scar in animal experiments. We report the case of a child with a distal esophageal stricture from lye ingestion managed with MMC. Despite repeated dilatations, at 1 year post injury, the stricture was 20% of esophageal diameter. Mitomycin C (4 microg/mL) was applied topically and circumferentially by endoscopy and repeated 4 months later. At 20 months follow-up, the child eats normally, and esophagram showed decreased stenosis (stricture was 50% of esophageal diameter). No complications were observed. Although controlled trials are required to confirm its efficacy, MMC should be considered as an adjunct in the management of caustic esophageal strictures in children.
Olutoye
Oluyinka O
OO
Pediatric Surgery Division, Michael E. DeBakey Department of Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX 77030-2399, USA. oolutoye@bcm.tcm.edu
Shulman
Robert J
RJ
Cotton
Ronald T
RT