A 13-year-old boy with type 1 esophageal atresia underwent a Sharli gastroplasty after birth.
A high digestive endoscopy performed for chronic dysphagia showed a fibrous Killian mouth, as well as the first signs of proximal esophagus showing a tortuosal stenosis and an anastomotic area.
The patient reported that, after meals, he had to tie his neck to the left and press between the muscular planes with his hand to facilitate bolus passage.
The first two dilations (separated for 2 months) were unsuccessful due to the folding of the esophagus, relapsing the clinic in a few days.
It was decided to place a non-recoverable prosthesis according to the age and weight of the child. A commercialized prosthesis of 23/18/23 x 8 was used.
As the proximal esophagus was very narrow and tortuous, and with the intention of correcting its position, it was decided to place it very high, just under Killian's mouth.
Two weeks later, the patient consulted urgently for cervical pain (antalgic position with elevation of the shoulders, immobility of the neck and contracture of the necrotic musculature for a cervical ulcer).
Conservative management with analgesia and enteral nutrition was achieved with CT scans.
Healing was observed in 15 days, although the stenosis persisted, requiring new dilations (the next 7 weeks after the placement of the prosthesis), even with a periodicity greater than the next hour before placing the prosthesis or two weeks later).
He has presented abundant hyperplastic tissue that has not been a problem of passage to the last endoscopies in which specific dilations have to be performed.
The prosthesis was reabsorbed 5 months after placement.
After a total of 6 dilatations, a mitomycin injection session was performed, with no apparent response.
Surgery was performed one year after stent placement.
