Metastatic Abscess as a Complication of Retrograde Esophageal Dilatation

Abstract

Retrograde dilatation of the esophagus for lye stricture has resulted in two patients with metastatic abscesses. One patient developed a brain abscess and the other a septic arthritis. It is postulated that: 1) the pressure from esophageal dilatation may result in microscopic perforation and/or bacteremia, and 2) that high dose steroid treatment facilitates bacterial seeding by impeding the formation of protective scar tissue. It is therefore felt that a longer time duration should lapse between termination of steroid therapy and the dilatation of an esophageal stricture.