**7. Stricture**

As the esophagus is healing following ingestion of a corrosive substance, the possibility of stricture should be assessed. Post-corrosive esophageal stricture is a complication that produces suffering for victims [9, 15, 17]. Esophageal dilation is a therapeutic intervention of choice to perform at the onset of stricture. If left until later, the procedure becomes more difficult, decreasing the success and increasing adverse events [21, 32–36]. Esophageal dilatation can be performed repeatedly according to schedule and using various dilators such as Maloney-Hurst, Savary-Gilliard, and Balloon dilator under the endoscopy, fluoroscopy, or both. Alternative

#### **Figure 1.**

*The treatment options for post-corrosive esophageal stricture. (A) Severe post-corrosive esophageal stricture; (B) Savary-Gilliard dilator; (C) endoscopic balloon dilation; (D) esophagectomy with open right thoracotomy; (E) esophagectomy with video-assisted thoracoscopic surgery (VATS); (F) reconstruction with cervical anastomosis after esophagectomy; (G, H) right side colonic conduit for esophageal replacement; and (I) subcutaneous colon interposition.*

*Acute Management in Corrosive Ingestion DOI: http://dx.doi.org/10.5772/intechopen.101475*


**Figure 2.**

*Schematic diagram of corrosive ingestion in esophageal injury.*

methods for post-corrosive esophageal stricture such as esophageal stenting [21, 37, 38], intralesional steroids [21, 39–43], and, Mitomycin-C [21, 44–48] have been published with various outcomes. These options might supplement dilation with better results. In cases of severe stricture, failure to dilate, or refractory strictures, surgery might be necessary (**Figure 1**) [4, 18, 19, 49–54].

Post-corrosive esophageal stricture should highly consider inpatient with Zargar grade 2b and 3a [4, 5, 8, 9, 16, 55]. Although various treatment strategies have been developed, none of them can provide outstanding results. Stricture prevention would be the ideal method. Corticosteroids reduce inflammation, but the benefit is inconclusive. Steroids cause severe adverse side effects such as esophageal candidiasis, gastric ulcer, ethmoiditis, osteomyelitis, and osteoporosis [56–58]. Recent studies have demonstrated that omeprazole with proton pump inhibitor activity could enhance healing, reduce stricture, and reduce the short-term risk of developing esophageal stricture in patients with 2b and 3a corrosive injuries [9, 59–61]. However, further studies of omeprazole are needed to corroborate these findings (**Figure 2**).
