Management of oesophageal strictures can be extremely challenging. Recently, biodegradable self-expanding stents have been used in people with benign strictures; this report describes the successful use of a polydioxanone stent (Infiniti Medical, Menlo Park CA USA) in a dog with a recurrent oesophageal stricture.

A three-year-old female neutered Staffordshire bull terrier presented with a progressive two-week history of regurgitation following surgery for septic peritonitis. Oesophagoscopy revealed a narrow, suspected reflux induced, oesophageal stricture (approximately 3 mm internal diameter), 10 cm caudal to the proximal oesophageal sphincter. The proximal oesophagus was markedly dilated. The area was infiltrated with triamcinolone (10 mg) via an endoscopic injection sheath. A balloon catheter was advanced through the stricture and inflated (external diameter 18mm - 3 atmospheres inflation pressure for three minutes) under endoscopic and fluoroscopic guidance. The dog recovered well and tolerated oral feeding. She received ranitidine, sucralfate and anti-inflammatory prednisolone. Three days later, the dog again regurgitated and repeat endoscopy revealed recurrence of the stricture, leading to repeat balloon dilation. Over the following nine weeks, the stricture needed repeat dilation on a further eight occasions; mitomycin-c was instilled as an anti-fibrotic agent on the final two occasions.

Following further regurgitation, the stricture was dilated to 18 mm and a tubular self-expanding polydioxanone stent (internal diameter 25x135 mm, ends flared to 31 mm) was placed within the oesophagus under fluoroscopic guidance, using a custom-made delivery device. The stent was then sutured to the oesophageal wall using three single interrupted polydioxanone sutures (one ventrally and on each lateral aspect) via a midline approach. Oesophagoscopy revealed the stricture in the middle of the stent which was well opposed to the wall. The dog made a good recovery, with no signs of discomfort.

Seven days later, the dog presented again with regurgitating. Oesophagoscopy revealed severe oesophagitis with inflamed mucosa protruding through the stent. Triamcinolone (20 mg) was injected into the most inflamed areas and a six-week tapering course of prednisolone, ranitidine and sucralfate commenced; the regurgitation resolved over the following seven days.

Fluoroscopy performed four months after placement revealed the stent was no longer present and there was no evidence of stricture. Oesophageal motility was subjectively delayed through this area and the dilation in the proximal oesophagus remained. The dog was tolerating a soft home-cooked diet well without further episodes of regurgitation.