Endoscopic management of congenital esophageal stenosis

Erminia Romeo, Francesca Foschia, Paola De Angelis, Tamara Caldaro, Giovanni Federici Di Abriola, Rosaalba Gambitta, Simona Buoni, Filippo Torroni, Valerio Pardi, Luigi Dall'Oglio

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Purpose: Congenital esophageal stenosis (CES) is a rare malformation. Endoscopic dilations represent a therapeutic option. This study retrospectively evaluated the efficacy and safety of a conservative treatment of CES. Patients and Methods: Patients diagnosed with CES since 1980 by a barium study or endoscopy were reviewed. Endoscopic ultrasonography (Olympus UM-3R-20-MHz radial miniprobe, Olympus Corporation, Tokyo, Japan), available from 2001, allowed for the differential diagnosis of tracheobronchial remnants (TBR) and fibromuscular hypertrophy (FMH) CES. All children underwent conservative treatment by endoscopic dilations (hydrostatic and Savary). Results: Forty-seven patients (20 men) had CES. Fifteen were associated with esophageal atresia; and 8, with Down syndrome. Mean age at the diagnosis was 28.3 months (range, 1 day to 146 months). Symptoms were solid food refusal, regurgitation, vomiting, and dysphagia. Congenital esophageal stenosis was located in the distal esophagus. Endoscopic ultrasonography demonstrated TBR and FMH in 6 patients. One hundred forty-eight dilations in 47 patients were performed. The stenosis healed in 45 (95.7%). Complications were 5 (10.6%) esophageal perforations, hydrostatic (3/32, or 9.3%), and Savary (2/116, or 1.7%). At follow-up, 1 patient with FMH CES and 1 patient with TBR CES required operation for persistent dysphagia. Conclusions: The conservative treatment yielded positive outcomes in CES. Endoscopic ultrasonography allows for a correct diagnosis of TBR/FMH CES. A surgical approach should be reserved for CES not responsive to dilations.

Original languageEnglish
Pages (from-to)838-841
Number of pages4
JournalJournal of Pediatric Surgery
Volume46
Issue number5
DOIs
Publication statusPublished - May 2011

Keywords

  • Congenital esophageal stenosis
  • Dilation
  • Perforation

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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