ASGE Annual Postgraduate Course at DDW: UPPER GI Only (On-Demand) | May 2019-7_Siddiqui

7_Siddiqui_Managing Esophageal Strictures

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In this article, Dr. Uzma D. Siddiqui discusses the management of esophageal strictures, leaks, and fistulas using endoscopic procedures. Esophageal strictures can be simple or complex, with different causes such as peptic ulcers, Schatzki's rings, or radiation. Endoscopic evaluation, including biopsies, can help determine the cause of the strictures. Dilation remains the main treatment for benign esophageal strictures, using either fixed-diameter dilator catheters or balloon dilators. In some cases, intralesional steroid injections can be added to inhibit inflammation and collagen formation.<br /><br />For esophageal fistulas and leaks, early recognition is crucial for successful closure. Various imaging and endoscopic techniques can be used to diagnose these conditions. Treatment options include diverting gastrointestinal secretions using fully covered metal stents or other off-label techniques such as sealants or endoscopic vacuum-assisted closure.<br /><br />Dr. Siddiqui emphasizes that a multidisciplinary approach is often necessary for managing these conditions effectively. Additionally, she discusses the importance of careful patient selection, appropriate equipment selection, and following established guidelines and techniques to achieve successful outcomes.<br /><br />Overall, this article provides an overview of endoscopic management options for esophageal strictures, leaks, and fistulas, highlighting the importance of tailored treatment plans and a comprehensive approach to patient care.

Keywords

esophageal strictures

esophageal leaks

esophageal fistulas

endoscopic procedures

management

benign esophageal strictures

dilation

intralesional steroid injections

early recognition

closure