10-year journey "unable to eat, unable to swallow
Patient H.T. P (50 years old, residing in Thai Nguyen) was admitted to the hospital in a state of severe exhaustion, mild fever and always feeling choked and stuck in the neck area. Few people would have thought that for the past 10 years, Ms. P has never had a full meal.
Through examination and endoscopy, doctors at the Center for Gastrointestinal Endoscopy and Functional Exploration (National Hospital for Tropical Diseases) discovered an alarming condition: At a position more than 38cm away from the tooth palate, the esophageal mucosa was strongly contracted, causing complete narrowing of the tube lumen.
This is a consequence of chronic fibrosis after a long course of treatment for esophageal fungus that lasted from a decade ago. The condition is so serious that the esophageal tract shrinks, without a fistula, making it almost impossible for the patient to swallow any solids.
Careful "bait" strategy
Dr. Tran Thanh Ha, Acting Director of the Center for Gastrointestinal Endoscopy and Functional Exploration - the person directly treating - shared: "Due to prolonged fibrosis, the esophageal lumen is only a few millimeters wide, and specialized scanners cannot pass through it. If we immediately use standard balloons, the risk of esophageal perforation is very high.
Faced with the difficult situation, the team of doctors decided to implement a cautious intervention plan, divided into many stages: Phase 1 (Decoction): Doctors use specialized small balloons for the bile ducts (sized under 10mm) to bypass the narrow gap, creating a premise for expanding the esophageal lumen. Phase 2 (Expansion): After 2 weeks, when the narrow position has stabilized, the patient continues to have a second expansion with a medium-sized esophageal balloon.
The results after the second dilation are very positive: The narrowed hole has been clearly improved, the patient has significantly reduced the feeling of choking and no longer has neck pain. However, because the calluses have existed for 10 years, making the elasticity of the esophagus poor, the patient will need to perform dilation a few more times to achieve optimal results, avoiding complications of bleeding or perforation of the esophagus.
Esophageal stricture is a condition where the esophageal lumen is narrowed, making food circulation to the stomach difficult. Initially, patients often only feel stuck when eating solid food (rice, meat), but later even drinking water or milk encounters obstacles. Common accompanying symptoms are: Thirst, vomiting, pain when swallowing and rapid weight loss due to malnutrition.
Dr. Tran Thanh Ha recommends: If not treated promptly, patients will fall into malnutrition and health exhaustion. Gastrointestinal endoscopy is currently the "golden method" for diagnosis. Through endoscopy, doctors not only intervene to expand the esophagus but can also perform a biopsy to rule out malignant causes (cancer).
