The most common disease cause of esophageal scar stenosis is the ingestion of corrosive agents such as strong alkalis or acids, leading to chemical burns of the esophagus. After healing, scar tissue contraction results in narrowing of the esophageal lumen. Additionally, scar contraction from reflux esophagitis, esophageal trauma, post-surgical procedures, or radiation therapy can also lead to scar stenosis. In children, esophageal chemical burns mostly occur due to accidental ingestion of household acidic or alkaline chemicals, while in adults, they are often caused by suicide attempts. This condition is both treatable and preventable.

bubble_chart Clinical Manifestations

1. Difficulty swallowing reappears 2-3 weeks after chemical injury, accompanied by signs such as weight loss and dehydration. 2. A history of long-term reflux esophagitis. After esophageal ulcers form, there may be slight hematemesis. 3. Postoperative esophageal stenosis often begins to show symptoms of dysphagia 2-3 weeks after surgery.

bubble_chart Diagnosis

1. A history of ingesting chemical corrosive agents, reflux esophagitis, esophageal trauma, surgery, or radiation therapy, followed by the onset of dysphagia. 2. Esophageal barium or iodized oil X-ray contrast can reveal the location, severity, and extent of esophageal stenosis. 3. Esophagoscopy (should be performed at least three weeks after injury) allows direct assessment of the stenosis.

bubble_chart Treatment Measures

1. In cases of perforation or necrosis following acute burns, emergency esophagectomy with cervical esophageal exteriorization and jejunostomy for feeding should be performed, followed by esophageal reconstruction later. 2. Early placement of a nasogastric tube after esophageal burns allows for feeding and prevents complete esophageal occlusion, facilitating and increasing the safety of future dilation. 3. Early administration of antibiotics and corticosteroids helps prevent or reduce inflammatory responses and minimizes subsequent scar formation. 4. For patients with long, severe strictures or those unresponsive to dilation, colon interposition should be performed to reconstruct the digestive tract.

bubble_chart Cure Criteria

bubble_chart Prognosis

Corrosive chemicals in households and workplaces should be specially labeled, properly stored, and strictly managed to prevent accidental ingestion. Patients with reflux esophagitis should undergo thorough examinations promptly to determine the disease cause and initiate pathogen-specific treatment as early as possible. During esophageal surgery, meticulous techniques should be employed, and tension at the anastomosis site should be avoided to minimize postoperative esophageal scar stenosis. In the acute phase of esophageal chemical burns, emetic formulas, gastric lavage, and esophageal examinations may exacerbate the injury and should not be used. Before performing an esophageal contrast study three weeks after the injury, fasting and rinsing the esophagus with clean water are necessary to improve diagnostic accuracy. Lesions in the cervical esophagus are often misdiagnosed as fistulas due to the rapid passage of contrast agents. Physicians must observe carefully to avoid misdiagnosing cervical lesions as fistulas and prevent treatment errors.