Incision therapy for unusual esophageal stricture

Milan S. Bassan, MBBS, FRACP, from the Department of Gastroenterology and Hepatology, Liverpool Hospital, in Liverpool and University of New South Wales, in Sydney, Australia presents this VideoGIE case, “Incision therapy for an unusual esophageal stricture.”

This is a case of a refractory benign esophageal stricture due to typhoid. As bougie and balloon dilation had been unsuccessful in dilating, the stricture needle knife incision therapy was used.

This video demonstrates the technique of needle knife incision therapy. It highlights the importance of using the correct anatomical landmarks to determine the safest depth of maximal incision as there was extensive structuring distal to the main stricture that meant the lumen was narrowed distal to the stricture as well.

Figure 1. Esophageal stricture after needle knife incision therapy.

In the correct clinical context, typhoid should be considered as a cause for benign esophageal stricture formation. Needle knife incision therapy is a useful technique to manage refractory benign esophageal strictures but extremely close attention must be paid to the anatomical landmarks to determine how deep the incisions can safely be made.

Find more VideoGIE cases online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

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