Nasogastric tube as protection for recurrent oesophageal stricture: a case report.
This report presents the case of an 8.5-year-old boy with Down syndrome after experiencing extensive caustic injury to the oesophagus and stomach resulting from the accidental ingestion of concentrated sulphuric acid. The patient had undergone 32 unsuccessful endoscopic oesophageal stricture dilatations and stenting procedures performed over a period of 15 mo following the accident. Surgical reconstruction of the oesophagus was not possible due to previous gastric and cardiac surgeries for congenital conditions. Before referring the patient for salivary fistula surgery, the patient received a nasogastric tube with perforations located above the upper margin of the oesophageal stenosis for the passage of saliva and fluid. The tube was well tolerated and improved swallowing; however the backflow of gastric contents caused recurrent infections of the respiratory tract. To overcome these problems, we developed a double lumen, varying diameter, perforated tube for protection of the oesophageal closure. This nasogastric tube was found to be safe and decreased the need for hospitalization and further endoscopic procedures. This newly developed tube can thus be considered as a treatment option for patients with recurrent oesophageal stenosis and contraindications for surgical oesophageal reconstruction.
Marek Woynarowski, Maciej Dądalski, Violetta Wojno, Mikołaj Teisseyre, Jakub Kmiotek, Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw 04-730, Poland.
Marek
M
Woynarowski
Marek Woynarowski, Maciej Dądalski, Violetta Wojno, Mikołaj Teisseyre, Jakub Kmiotek, Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw 04-730, Poland.
Maciej
M
Dądalski
Marek Woynarowski, Maciej Dądalski, Violetta Wojno, Mikołaj Teisseyre, Jakub Kmiotek, Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw 04-730, Poland.
Violetta
V
Wojno
Marek Woynarowski, Maciej Dądalski, Violetta Wojno, Mikołaj Teisseyre, Jakub Kmiotek, Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw 04-730, Poland.
Mikołaj
M
Teisseyre
Marek Woynarowski, Maciej Dądalski, Violetta Wojno, Mikołaj Teisseyre, Jakub Kmiotek, Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw 04-730, Poland.
Marek
M
Szymczak
Marek Woynarowski, Maciej Dądalski, Violetta Wojno, Mikołaj Teisseyre, Jakub Kmiotek, Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw 04-730, Poland.
Anna
A
Chyżyńska
Marek Woynarowski, Maciej Dądalski, Violetta Wojno, Mikołaj Teisseyre, Jakub Kmiotek, Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw 04-730, Poland.
Leszek
L
Hurkała
Marek Woynarowski, Maciej Dądalski, Violetta Wojno, Mikołaj Teisseyre, Jakub Kmiotek, Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw 04-730, Poland.
Emil
E
Płowiecki
Marek Woynarowski, Maciej Dądalski, Violetta Wojno, Mikołaj Teisseyre, Jakub Kmiotek, Department of Gastroenterology, Hepatology and Feeding Disorders, Children's Memorial Health Institute, Warsaw 04-730, Poland.
Jakub
J
Kmiotek
D000059:Accidents; D002057:Burns, Chemical / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D002424:Caustics / Q000009:adverse effects*; D002648:Child; D000075202:Contraindications; D004314:Down Syndrome / Q000150:complications / Q000175:diagnosis; D004940:Esophageal Stenosis / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy*; D004945:Esophagoscopy; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000295:instrumentation*; D008297:Male; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures; D012008:Recurrence; D015607:Stents; D013464:Sulfuric Acids / Q000009:adverse effects*; D016896:Treatment Outcome
D002424:Caustics; D013464:Sulfuric Acids; C033158:sulfuric acid
Corrosive oesophageal stenosis; Nasogastric tube; Oesophageal dilatation; Oesophageal stenting