City Hospital Inserts Stent in a Boy’s Food Pipe after He Mistakenly Drinks Acid
Kolkata, January 30, 2018: A 10-year old boy consumed sulphuric acid instead of cold drink by mistake. His esophagus, in other words, the food pipe, a muscular tube connecting the throat (pharynx) with the stomach, was burnt by the acid. He was unable to swallow his own saliva, leave aside food and water.
The condition of Vishwa (name changed) was deteriorating and the doctorsof a local hospital referred him to Medica Superspecialty Hospital. When theboy along with his parents visited Medica, he had significant malnutritionowing to inability to eat for almost a month and weighed mere 20 kilograms(kgs).
After examining the child and seeing the barium swallow X-ray, thedoctors found that the X-ray showed a severely narrowed lower end of esophaguswith the contrast barely entering the stomach. “It was not only difficult toopen up the narrowed segment but it was highly risky as he was just 10 year oldand that too with malnutrition,” recalled Dr. Jayanta Samanta,Consultant Gastroenterologist, Medica Superspecialty Hospital.
When the child visited Medica, he was taken up for upper GI endoscopyand a tight narrowing was noted in lower pat of esophagus. “The stricture(narrowing) was dilated in the first session in the upper part and a feedingtube, popularly known as Ryle’s tube, was placed through the narrowing areainto the stomach for the feeding so that the malnutrition of the kid could becorrected.
After a month, the kid was taken up for dilatation of the narrowed partof esophagus. During the procedure, a suspected fistulous communication wasdetected between the stricture and the left bronchus (respiratory tube).Moreover, the stricture seemed tight and difficult for simple dilatation withballoon, as is usually done and hence the dilatation was postponed. Later ontwo dilatation sessions which continued for a month helped the kid as he wasthen able to take liquids, said Dr. Samanta.
A decision was then required to be taken whether to take up the kid fora major surgery to resect out the narrowed part of the esophagus and join theremaining part directly with the stomach versus placement of a metallic stentacross the narrowed part of the esophagus. Another intriguing issue was to geta kid-sized stent, as the commonly available stents in the market, are foradults. The parents wanted to go with the stent placement procedure to avoid amajor surgery for the kid, explained Dr. Pradeepta Kumar Sethy,Director, department of Gastroenterology, Medica Superspeciality Hospital.
“Placement of fully covered metallic stents for this kind of fistuloustract is well recommended for adults but placement of such stents in kids isvery rare in practice because of the technical difficulties underlying theprocedure,” said Dr. Sethy.
Vishwa was taken up for metallic stent placement in his esophagus afterthe dilatation sessions were over. Under general anesthesia, Dr. Samanta andDr. Sethy placed the stent endoscopically with no complications. Once the stentwas placed, the child had an uneventful and dramatic recovery. After a day ofthe procedure, the child was allowed to take liquid diet followed by semi-solidfood. After 2 weeks, the young boy resumed his normal activities like going toschool, to the delight of the parents and neighbourhood.
Within 6 weeks, the stent was removed recently, when the fistula washealed and the esophagus opened up. Post stent removal, he was under theobservation of GI team for more than a month. Vishwa is all set to conquer theworld now. “We are happy to see that Vishwa is leading a normal life againafter suffering for long. Thankfully the patient has recovered quite fast. Thewhole procedure performed by the GI team is unique and deserves all theaccolades,” said Dr. Alok Roy, Chairman, Medica Group of Hospitals.