Corrosive intake with extensive esophageal and gastric damage

This was a forty year old gentleman who had ingested corrosive (alkaline toilet cleaner). The barium study showed a thin streak of contrast outlining the esophagus (A: green arrows). The stomach was small and deformed,  especially the antral region (B: green arrows marking the fundus and body; red arrows marking the antral area). The case was referred to the surgeon but the surgical team insisted for us to have a go at esophageal dilatation. They had hoped the esophagus could be salvaged. Things were worse than expected on endoscopy with extensive scarring and fibrosis and friability (C). We partially dilated the upper esophagus with a 30 French Savary dilator but it was the same story lower down. Further dilatation was abandoned and the case was referred for esophagectomy and gastrectomy with possible colonic interposition.