title: Benign esophageal stricture after thermal injury treated with esophagectomy and ileocolon interposition.
abstract: Thermal injuries of the esophagus are rare causes of benign esophageal stricture, and all published cases were successfully treated with conservative management. A 28-year-old Japanese man with a thermal esophageal injury caused by drinking a cup of hot coffee six months earlier was referred to our hospital. The hot coffee was consumed in a single gulp at a party. Although the patient had been treated conservatively at another hospital, his symptoms of dysphagia gradually worsened after discharge. An upper gastrointestinal endoscopy and computed tomography revealed a pin-hole like area of stricture located 19 cm distally from the incisors to the esophagogastric junction, as well as circumferential stenosis with notable wall thickness at the same site. The patient underwent a thoracoscopic esophageal resection with reconstruction using ileocolon interposition. The pathological findings revealed wall thickening along the entire length of the esophagus, with massive fibrosis extending to the muscularis propria and adventitia at almost all levels. Treatment with balloon dilation for long areas of stricture is generally difficult, and stent placement in patients with benign esophageal stricture, particularly young patients, is not yet widely accepted due to the incidence of late adverse events. Considering the curability and quality-of-life associated with a long expected prognosis, we determined that surgery was the best treatment option for this young patient. In this case, we decided to perform an esophagectomy and reconstruction with ileocolon interposition in order to preserve the reservoir function of the stomach and to avoid any problems related to the reflux of gastric contents. In conclusion, resection of the esophagus is a treatment option in patients with benign esophageal injury, especially in cases involving young patients with refractory esophageal stricture. In addition, ileocolon interposition may help to improve the quality-of-life of patients.
authors.affiliation: Toshihiro Kitajima, Kota Momose, Seigi Lee, Shusuke Haruta, Hisashi Shinohara, Masaki Ueno, Harushi Udagawa, Department of Digestive Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kitajima
authors.affiliation: Toshihiro Kitajima, Kota Momose, Seigi Lee, Shusuke Haruta, Hisashi Shinohara, Masaki Ueno, Harushi Udagawa, Department of Digestive Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Momose
authors.affiliation: Toshihiro Kitajima, Kota Momose, Seigi Lee, Shusuke Haruta, Hisashi Shinohara, Masaki Ueno, Harushi Udagawa, Department of Digestive Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan.
authors.forename: Seigi
authors.initials: S
authors.lastname: Lee
authors.affiliation: Toshihiro Kitajima, Kota Momose, Seigi Lee, Shusuke Haruta, Hisashi Shinohara, Masaki Ueno, Harushi Udagawa, Department of Digestive Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan.
authors.forename: Shusuke
authors.initials: S
authors.lastname: Haruta
authors.affiliation: Toshihiro Kitajima, Kota Momose, Seigi Lee, Shusuke Haruta, Hisashi Shinohara, Masaki Ueno, Harushi Udagawa, Department of Digestive Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Shinohara
authors.affiliation: Toshihiro Kitajima, Kota Momose, Seigi Lee, Shusuke Haruta, Hisashi Shinohara, Masaki Ueno, Harushi Udagawa, Department of Digestive Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Ueno
authors.affiliation: Toshihiro Kitajima, Kota Momose, Seigi Lee, Shusuke Haruta, Hisashi Shinohara, Masaki Ueno, Harushi Udagawa, Department of Digestive Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Toshihiro Kitajima, Kota Momose, Seigi Lee, Shusuke Haruta, Hisashi Shinohara, Masaki Ueno, Harushi Udagawa, Department of Digestive Surgery, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan.
authors.forename: Harushi
authors.initials: H
authors.lastname: Udagawa
mesh_terms: D000328:Adult; D002056:Burns / Q000175:diagnosis / Q000209:etiology*; D003069:Coffee / Q000009:adverse effects*; D003106:Colon / Q000601:surgery*; D004940:Esophageal Stenosis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016629:Esophagectomy; D004945:Esophagoscopy; D004947:Esophagus / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D005355:Fibrosis; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003069:Coffee
keywords: Benign esophageal stricture; Esophageal resection; Ileocolon interposition; Thermal injury; Video-assisted thoracic surgery
references.citation: Int J Cancer. 1987 Jun 15;39(6):708-9
references.pmid: 3583450
references.citation: Endoscopy. 2009 Apr;41(4):363-73
references.pmid: 19340743
references.citation: Ann Surg. 2010 Aug;252(2):271-80
references.pmid: 20622655
references.citation: Chest. 2002 May;121(5):1701-3
references.pmid: 12006465
references.citation: AJR Am J Roentgenol. 1997 Nov;169(5):1281-4
references.pmid: 9353442
references.citation: Dysphagia. 1996 Winter;11(1):72-4
references.pmid: 8556881
references.citation: Radiology. 1993 Jun;187(3):667-71
references.pmid: 8497612
references.citation: N Engl J Med. 1998 Aug 13;339(7):480-1
references.pmid: 9705693
references.citation: Am Surg. 2002 Aug;68(8):720-3
references.pmid: 12206608
references.citation: J Korean Med Sci. 2010 Mar;25(3):489-91
references.pmid: 20191054
references.citation: Korean J Radiol. 2010 Sep-Oct;11(5):497-506
references.pmid: 20808692
references.citation: Ann Thorac Surg. 2009 Nov;88(5):1647-53
references.pmid: 19853126
references.citation: Int J Colorectal Dis. 2002 Jul;17(4):268-74
references.pmid: 12073076
references.citation: Ann Surg. 1978 Nov;188(5):606-10
references.pmid: 718285
references.citation: Dis Esophagus. 2002;15(2):101-5
references.pmid: 12220414
references.citation: Korean J Intern Med. 2007 Mar;22(1):59-62
references.pmid: 17427650
references.citation: Eur Radiol. 2009 Feb;19(2):384-90
references.pmid: 18726598
references.citation: Gastrointest Endosc. 2005 Jul;62(1):158-60
references.pmid: 15990841
references.citation: Plast Reconstr Surg. 2008 Nov;122(5):153e-154e
references.pmid: 18971697
references.citation: Gastrointest Endosc. 1999 Aug;50(2):282-3
references.pmid: 10425431
references.citation: J Gastrointest Surg. 1999 Jul-Aug;3(4):383-8
references.pmid: 10482690
references.citation: Ann Thorac Surg. 1999 Feb;67(2):313-7; discussion 317-8
references.pmid: 10197646