Effectiveness of Bougie Dilation for the Management of Corrosive Esophageal Strictures

Background And Study Aims: Caustic ingestion caused by swallowing a detergent can produce a progressive and devastating injury in the esophagus and stomach. One of the most important outcomes of the corrosive oesophagitis is the stricture formation, which is resistant to treatment. The aim of this study was firstly to determine the relation between agent, inflammation and stricture, and secondly investigate the efficiency of dilation in patients having esophageal stricture due to corrosive oesophagitis.

Patients And Methods: In this study, 58 cases with post caustic oesophagitis, which had been admitted to our clinic or emergency department between January 1999 and December 2004, were assessed retrospectively. Dilation of esophageal stricture of the cases was performed by Savary-Gilliard bougies.

Results: The most frequently ingested substance was alkaline (48.2%). Concerning all the patients, the most frequent location of caustic injury was upper esophagus (36.2%), and grade I injury was the most frequently encountered one (34.4%). Thirty patients (51.7%) developing stricture were treated by repeated dilations. The most common location of stricture was middle esophagus (50%), and severe stricture was the most common one among all stricture grades (46.7%). Alkaline ingestions yielded more severe stricture than acids. Eight of the patients with stricture (26.6%, 8/30), who didn't respond to periodic esophageal dilation, underwent esophageal resection or bypass surgery.

Conclusion: Dilation with Savary-Gilliard bougies is a quite effective method for stricture after corrosive oesophagitis.