Palliative approaches for malignant esophageal obstruction include which of the following?

• A. Esophageal stenting
• B. Dilation
• C. Feeding tube support
• D. All of the above

Answer: (D)

Relieving swallowing difficulty and preserving nutrition are the goals in palliative care for malignant esophageal obstruction. Esophageal stenting bypasses the tumor and quickly restores the lumen, often producing rapid improvement in swallowing and quality of life. Dilation can temporarily widen a narrowed segment to ease passage, and is sometimes used when a stent isn’t suitable or as a bridge before other measures, though its effect may be short-lived and carries a perforation risk. Feeding tube support ensures adequate nutrition when oral intake isn’t safe or sufficient, via a nasogastric tube or a more durable gastrostomy/jejunostomy. Because each approach targets a different aspect of the problem, they are all considered part of palliative management, so all of the above best fits.