PAEA Surgery End Of Rotation (EOR) Practice Exam

Which treatment is considered for severe cases of esophageal stricture?

1. Surgical resection

2. Esophagectomy with colon interposition

3. Endoscopic dilation

4. Medication therapy

The correct answer is: Esophagectomy with colon interposition

In cases of severe esophageal stricture, the treatment approach often requires significant intervention to restore normal function and relieve symptoms. Esophagectomy with colon interposition is a definitive surgical procedure that is utilized specifically for complicated or severe strictures that do not respond to less invasive management options. This technique involves the removal of the affected segment of the esophagus—often due to causes such as malignancy, severe injury, or chronic inflammation—and replacing it with a segment of the colon. This option is particularly relevant when the stricture significantly obstructs the esophagus or when there is concern regarding malignant transformation or other complications that cannot be managed through simpler methods such as dilation or stenting. The use of colon as a substitute for the esophagus can provide a functional conduit for food and liquids, thus restoring swallowing abilities when less invasive procedures are ineffective. The other treatments like endoscopic dilation are typically used for mild to moderate strictures, while medication therapy is more suited for underlying conditions rather than direct management of the stricture itself. Surgical resection is less frequently performed when specific conditions justify a complete esophageal removal and reconstruction, which is what esophagectomy with colon interposition accomplishes. Hence, this choice represents the most comprehensive and effective strategy for addressing severe