CAPS papersEndoscopic management of congenital esophageal stenosis
Section snippets
Patients and methods
From January 1980 to March 2010, 47 patients with CES diagnosed by a barium study or endoscopy were reviewed. Endoscopic ultrasonography (EUS) (Olympus UM-3R-20-MHz radial miniprobe) was available from 2001 for the diagnosis of TBR CES and FMH CES.
All children underwent conservative treatment by endoscopic dilations. Dilations were performed with a guidewire and spot fluoroscopy under general anesthesia. Hydrostatic dilators (Rigiflex Boston Scientific, Natick, MA, USA, with 8-, 10-, and 12-mm
Results
Forty-seven consecutive patients were diagnosed with CES. The female-to-male ratio was 1.35:1 (27 women and 20 men), and the mean age at the time of diagnosis was 28.3 months (range, 1 day to 146 months). In 8 patients (17%), the CES was associated with Down syndrome; and in 15 patients (32%), the CES was associated with type C esophageal atresia and a tracheoesophageal fistula (EA-TEF). In 32 patients (68%), the predominant clinical sign was dysphagia with regurgitation as well as solid food
Discussion
Congenital esophageal stenosis is rarely diagnosed in neonates because the onset of symptoms usually begins at the introduction of solid food at the age of 4 to 10 months. A history of dysphagia to solid food and a lack of weight gain are important in establishing a suspicion of CES.
An esophagogram generally shows a short (0.5-1 cm) lower esophageal stricture, characterized by a smooth, continuous area of concentric narrowing. Sometimes, CES is an incidental finding during an esophagoscopy or
Acknowledgment
The authors thank Geoffrey Blair for scientific support and VISES ONLUS for financial support.
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