potassium-permanganate and Esophageal-Stenosis

The treatment of double strictures in the airway and the oesophagus has always been time-consuming and causes additional suffering. A new technique using an open approach with the placement of two Montgomery silicone T-tubes to support and dilate the two strictures was successfully performed on a patient after caustic substance ingestion. Scar tissue was incised before two T-tubes were positioned into the larynx and oesophagus through a laryngo-fissure approach. The tubes remained in position for one year and no complications occurred. No foreign body sensation or prosthesis migration was observed and the patient had nearly normal peroral alimentation. After removal of the tubes, follow-up for an additional two years revealed no recurrence of the stenoses and normal alimentation without stridor. This technique permits simultaneous stenting of strictures of the larynx and oesophagus by using a connecting suture between the superior parts of two stents.

Topics: Adolescent; Burns, Chemical; Dilatation; Esophageal Stenosis; Female; Humans; Laryngostenosis; Potassium Permanganate; Stents

A case of oesophageal stenosis following ingestion of potassium permanganate as an abortifacient is described.. A case is reported of a 20-year-old married female who developed esophageal stricture following consumption of potassium permanganate as an abortifacient. The woman was admitted in May 1985 with progressive dysphagia of 4 weeks duration. A week before the onset of symptoms, she was given, by a "village quack", a powder to be taken with sugar for inducing abortion in the 1st trimester of pregnancy. Immediately after consuming about 25 g of this powder, the patient experienced intense pain in the retrosternal area. She vomited repeatedly the whole day and aborted 12 hours later. Soon thereafter, she began to have difficulty in swallowing, which increased progressively over the next month before she came to the hospital for advice. Examination revealed mild dehydration. The oral cavity did not show any ulceration. A barium swallow showed a long, narrow stricture of the esophagus. Endoscopy revealed a mild esophagitis from 20-24 cm, beyond which a long, narrow stricture could be seen. A feeding tube was put in, and 2 weeks later endoscopic dilatation with Eder-Puestow dilators was begun. She underwent 6 sittings of dilatation which led to complete recovery of her symptoms. A followup barium study was not done since the patient had conceived again. A sample of the "powder" which she had consumed was chemically analyzed and found to be potassium permanganate. This case illustrates that potassium permanganate (KMn04) can cause severe chemical burns to the esophagus, which on healing may reult in fibrosis leading to stricture formation.

Topics: Abortifacient Agents; Adult; Burns, Chemical; Esophageal Stenosis; Female; Humans; Potassium Permanganate