Esophageal balloon dilatation – a complication

Abstract

Esophageal stenosis is a narrowing of the esophageal lumen, which can vary in length – from about a couple of millimetres to a few centimetres. The reasons which can lead to such stenosis can be: congenital, for example atresia, esophageal ring; as a consequence of esophagitis after consumption of corrosive agents, and due to esophageal tumor processes or tumors of neighboring structures too. The therapeutical approach is different and depends on the reason and the condition: resection of the engaged segment, stenting, balloon dilatation, injecting of botulinum toxin. This was the case of a 47-year-old female patient who was admitted to the gastroenterology department with complaints of difficulty swallowing solid foods and liquids for a long time, as well as vomiting of the food immediately after eating. She previously underwent therapy with proton pump inhibitors, without any significant effect. After laboratory, imaging and endoscopic examinations, a stenosis of the distal part of the esophagus was found. Proximally, the esophagus was dilated and contained food residue. The chosen therapeutic approach was balloon dilatation of the engaged segment. Twelve days after the balloon dilatation, the patient presented to the hospital again, with complaints of pain in the thorax, fever and elevated inflammatory markers. Diagnostic imaging detected a heterogeneous collection, located in the distal part of the esophagus, which was narrowing the lumen. During the draining under endosonography control, a thick, pus-like fluid was flowing out.