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Background <p>While dilation therapy is the primary treatment for benign esophageal strictures, the recurrence or lack of responsiveness of strictures to this treatment can necessitate additional or repeated treatment. The objective of this study was to investigate the efficacy and safety of intralesional steroid injections (ISIs) in addition to dilation in patients with refractory benign esophageal strictures.</p> Patients and methods <p>The clinical trial included 21 pediatric patients with refractory benign esophageal strictures. An upper gastrointestinal endoscopy was conducted to the level of the stricture, after which esophageal dilation was performed. Subsequently, endoscopy was repeated, and a steroid was injected intralesionally under direct endoscopic vision. The procedure's efficacy was evaluated over 12&#xa0;months by assessing several parameters, including the number of dilatations, maximum dilator size, periodic dilatation index (PDI), and dysphagia score.</p> Results <p>The response to steroids was successful in 17 patients (81%) and unsuccessful in 4 patients (19%). The number of dilatations, PDI, and dysphagia scores were significantly reduced following ISIs in comparison to pre-injection. Conversely, the maximum dilator size significantly increased following ISIs compared to the pre-injection period. No side effects following steroid injections in children with esophageal strictures were reported in this study.</p> Conclusion <p>Intralesional steroid injection combined with endoscopic dilatation is a safe and effective therapy for refractory benign esophageal strictures, indicating the efficacy of this modification in minimizing the need for recurrent dilations. Furthermore, the maximal dilator size, periodic dilation index, and dysphagia score showed considerable improvements.</p>

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Safety and efficacy of steroid injection with endoscopic dilatation in pediatric refractory benign esophageal stricture

  • 期刊论文

  • 发表日期：

    2025年6月18日

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  • Mohamed Anwar,
  • Sayed Elhady,
  • Mohamed Shahin,
  • Mohammad Daboos,
  • Mohamed Magid,
  • Ahmed Azab,
  • Ahmed Abdelaziz,
  • Amir Asla

摘要

Background

While dilation therapy is the primary treatment for benign esophageal strictures, the recurrence or lack of responsiveness of strictures to this treatment can necessitate additional or repeated treatment. The objective of this study was to investigate the efficacy and safety of intralesional steroid injections (ISIs) in addition to dilation in patients with refractory benign esophageal strictures.

Patients and methods

The clinical trial included 21 pediatric patients with refractory benign esophageal strictures. An upper gastrointestinal endoscopy was conducted to the level of the stricture, after which esophageal dilation was performed. Subsequently, endoscopy was repeated, and a steroid was injected intralesionally under direct endoscopic vision. The procedure's efficacy was evaluated over 12 months by assessing several parameters, including the number of dilatations, maximum dilator size, periodic dilatation index (PDI), and dysphagia score.

Results

The response to steroids was successful in 17 patients (81%) and unsuccessful in 4 patients (19%). The number of dilatations, PDI, and dysphagia scores were significantly reduced following ISIs in comparison to pre-injection. Conversely, the maximum dilator size significantly increased following ISIs compared to the pre-injection period. No side effects following steroid injections in children with esophageal strictures were reported in this study.

Conclusion

Intralesional steroid injection combined with endoscopic dilatation is a safe and effective therapy for refractory benign esophageal strictures, indicating the efficacy of this modification in minimizing the need for recurrent dilations. Furthermore, the maximal dilator size, periodic dilation index, and dysphagia score showed considerable improvements.