Evaluation and management of congenital esophageal stenosis: a rare entity

Jiledar Rawat; Anand Pandey; Sudhir Singh; Sarita Singh

doi:10.18203/2349-2902.isj20164480

Authors

Jiledar Rawat Department of Pediatric Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
Anand Pandey Department of Pediatric Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
Sudhir Singh Department of Pediatric Surgery, King George’s Medical University, Lucknow, Uttar Pradesh, India
Sarita Singh Department of Anesthesia, King George’s Medical University, Lucknow, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20164480

Keywords:

Congenital esophageal stenosis, Esophageal dilation, Tracheobronchial remnants

Abstract

Background:Congenital esophageal stenosis (CES) is an uncommon condition presenting with swallowing problems. It has been classified into three types. Clinically, the condition is manifested as dysphagia. This is more common after introduction of semisolid to solid foods. We present the management strategy of this uncommon entity.

Methods: This study ranged from January 2009 to January 2015. Six patients of CES were included in the study. The patients were diagnosed by contrast swallow study and upper gastrointestinal endoscopy. The initial management included esophageal dilation under fluoroscopy guidance. In case of failed dilation, thoracotomy, resection of the stenotic segment and primary esophageal anastomosis was performed. If required, antireflux procedure was added.

Results:In 4 patients, the stenosis was in middle esophagus. Of these, one had associated esophageal diverticulum. In 2 patients, the stenosis was in the lower esophagus. These patients also underwent antireflux surgery. After the surgery, all patients were able to swallow properly. There was no problem in the follow up except in one patient, who needed dilation in the follow up. He responded to the dilation.

Conclusions:High index of suspicion is needed to diagnoses this condition. Dilation may not be successful to treat all type all type of CES, for whom surgery will be needed. Long term outcome may be satisfactory.

Metrics

Metrics Loading ...

References

Amae S, Nio M, Kamiyama T, Ishii T, Yoshida S, Hayashi Y. Clinical characteristics and management of congenital esophageal stenosis: a report on 14 cases. J Pediatr Surg. 2003;38:565-70.

Fekete NC, Backer A, Jacob LS, Pellerin D. Congenital esophageal stenosis. Pediatr Surg Int. 1987;2:86-92.

Jain V, Yadav DK, Sharma S, Jana M, Gupta DK. Management of long segment congenital esophageal stenosis: A novel technique. J Indian Assoc Pediatr Surg. 2016;21:150-2.

Valerio D, Jones PF, Stewart AM. Congenital oesophageal stenosis. Arch Dis Child. 1977;52:414-6.

Ramareddy RS, Alladi A. Review of esophageal injuries and stenosis: lessons learn and current concepts of management. J Indian Assoc Pediatr Surg. 2016;21(3):139-4.

Harmon CM, Coran AG. Congenital anomalies of the esophagus. In: Coran AG, Adzick NS, Krummel TM, Laberge J, Shamberger RC, Caldmone AA (editors). Pediatric Surgery. 7th ed. Philadelphia: Elsevier Saunders; 2012:893-918.

Usui N, Kamata S, Kawahara H, Sawai T, Nakajima K, Soh H, et al. Usefulness of endoscopic ultrasonography in the diagnosis of congenital esophageal stenosis. J Pediatr Surg. 2002;37:1744-6.

Dalloglio L, Caldaro T, Foschia F, Faraci S, Abriola GF, Rea F et al. Endoscopic management of esophageal stenosis in children: New and traditional treatments. World J Gastrointest Endosc. 2016;8:212-9.

Grabowski ST, Andrews DA. Upper esophageal stenosis: two case reports. J Pediatr Surg. 1996;31:1438-9.

Feng FH, Kong MS. Congenital esophageal stenosis treated with endoscopic balloon dilation: report of one case. Acta Paediatr Taiwan. 1999;40:351-3.

Kurian JJ, Jehangir S, Varghese IT, Thomas RJ, Mathai J, Karl S. Clinical profile and management options of children with congenital esophageal stenosis: a single center experience. J Indian Assoc Pediatr Surg. 2016;21:106-9.