Caustic esophageal stricture

Case contributed by Antonio Rodrigues de Aguiar Neto
Diagnosis almost certain

Presentation

Dysphagia and odynophagia, could only ingest liquids and occasionally pasty food. History of caustic ingestion five years earlier.

Patient Data

Age: 7 years
Gender: Male
Barium

There is a long segment smooth stricture involving most of the thoracic esophagus, more severe in the upper and middle third. There is no extraluminal leakage of contrast. Few air bubbles are present as lucent filling defects.

The contrast flowed to the stomach and pylorus into the duodenum.

Case Discussion

Caustic ingestion in children is usually accidental 1,2,5. Corrosive esophagitis can cause esophageal perforation, fistulas, stricture formation in the esophagus, stomach lesions, and may progress to the development of esophageal carcinoma 1-5.

The barium contrast studies provide essential information regarding the location, number, length, and tightness of the esophageal strictures 3,5. This case illustrates the typical radiological features of long segment esophageal stenosis in a boy who had ingested a caustic substance some years before.

Case courtesy

  • Rennah Gonçalves, MD - PGY-1, Radiology Resident, Department of Radiology
  • Antonio Rodrigues de Aguiar Neto, MD - Radiologist, Department of Radiology
  •  Hospital da Restauração – Recife, PE – Brazil

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