Endoscopic puncture and recanalization in a child with corrosive esophageal stenosis and atresia: case report and literature review

Corrosive esophageal stenosis and atresia represent severe late complications of caustic alkali ingestion, often leading to discontinuity of the esophagus and loss of oral feeding capability. While traditional surgical reconstruction is highly invasive and carries significant morbidity, endoscopic minimally invasive recanalization may represent a potential alternative in highly specific scenarios. We report a case of an 11-year-old boy who developed long-segment esophageal stenosis and complete atresia following accidental alkali ingestion. Successful esophageal recanalization was achieved using a combined bidirectional endoscopy approach under fluoroscopic guidance, involving puncture, balloon dilation, and the placement of a fully covered self-expandable metal stent (FCSEMS). Following the procedure, the patient resumed an oral diet and demonstrated favorable outcomes at midterm follow-up. This case demonstrates that endoscopic recanalization appears to be a feasible option for selected pediatric patients with short-segment atresia and suitable anatomy. Its success hinges on meticulous preprocedural assessment, multidisciplinary collaboration, and strict adherence to indications. Surgery is not the only pathway, and treatment must be individualized based on specific patient conditions.