Clinical characteristics of congenital esophageal stenosis distal to associated esophageal atresia

Kawahara, Hiroyuki; Imura, Kenji; Yagi, Makoto; Kubota, Akio

doi:10.1067/msy.2001.109064

Cited by 55 publications

(43 citation statements)

References 27 publications

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“…This association is said to be extremely rare [3]. However, we believe like others that this association is common [4,5]. In the present study the incidence was 14%.…”

Section: Discussionmentioning

confidence: 40%

“…Congenital esophageal stenosis is an intrinsic stenosis that may be present at birth but not necessarily symptomatic [12]. The diagnosis of CES is suspected in a neonate with EA if a size 8 French nasogastric tube cannot be passed into the stomach [4,12]. However, passage of the tube down to the stomach does not rule out CES [12].…”

Section: Discussionmentioning

confidence: 98%

“…Unfortunately, the diagnosis is only confirmed by histologic picture [2]. The incidence of CES associated with esophageal atresia (EA) ranges from 0.4% [3] to 14% [4]. The presence of gastro-esophageal reflux (GER), the site affected and the involvement of the anastomotic site are controversial issues that need to be verified.…”

Section: Introductionmentioning

confidence: 99%

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Congenital esophageal stenosis associated with esophageal atresia: new concepts

et al. 2007

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Congenital esophageal stenosis (CES) is suspected by a fixed intrinsic narrowing of the esophagus that affects the normal swallowing mechanism. The diagnosis is only confirmed by histopathologic picture, which may show fibromuscular disease (FMD) or tracheobronchial remnants (TBR). The latter involves ciliated pseudo stratified columnar epithelium, seromucous glands or cartilage each alone or in combination. The aim of this study is to document the usefulness of histologic picture of surgical specimens obtained from the lower esophageal pouch (LEP) during primary repair in detecting cases of CES associated with esophageal atresia (EA) with or without tracheoesophageal fistula (TEF). Over an 8-year period, 57 consecutive cases operated upon for EA with or without TEF were subjected for histologic examination of surgical specimens obtained from the tip of the LEP. Cases that histologically showed FMD or TBR were included. The usefulness of this histologic picture as a diagnostic and therapeutic aid is assessed. Methods of treatment and outcome were also reviewed. Eight patients out of 57 (14%) had a histologic picture suggestive of CES, two with FMD, four with TBR without cartilage and two with cartilage. Out of 57 patients, 23 developed strictures, six of them had positive biopsies suggestive of CES. One patient with TBR without cartilage did not have stricture. Another case of pure atresia had LEP resection and gastric pull up showed cartilage involving the whole lower esophagus. Excluding the case of pure EA with gastric pull up, all patients suffered from feeding problems and recurrent aspiration. Fluoroscopic barium studies showed late onset minor dysmotility in five patients and late onset major dysmotility in two. All cases studied showed significant gastro-esophageal reflux (GER). Stricture was seen at the anastomotic site extending distally in the two fibromuscular cases and one case with cartilage, at the anastomotic site in three cases with TBR without cartilage. Anti reflux surgical procedures were performed in four patients without benefit in two patients with major dysmotility. Dilatation was successful in the three patients with TBR without cartilage. One patient with cartilage had resection of the anastomotic site and required frequent dilatations and is now doing well. A case of FMD did not improve after frequent dilatations and myotomy together with Nissen's fundoplication and required resection while the other case of FMD responded partially to dilatations. Cartilage in cases of CES requires surgical resection. Those with TBR without cartilage may not develop stricture. If stricture develops, it responds well to dilatation and patients have good clinical outcomes. Unlike isolated CES, GER is a significant feature in CES with EA. Anti reflux procedures should be avoided before definitive surgery for the stricture and if necessary a partial wrap with gastrostomy is recommended. CES should be considered in the etiology of anastomotic stricture. Taking a surgical specimen routinely from the tip of th...

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“…This association is said to be extremely rare [3]. However, we believe like others that this association is common [4,5]. In the present study the incidence was 14%.…”

Section: Discussionmentioning

confidence: 40%

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Congenital esophageal stenosis associated with esophageal atresia: new concepts

et al. 2007

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“…Esophageal perforation, aspiration pneumonia and cardiac arrest are reported after dilatation. 7 Surgical intervention should be considered when sufficient dilatation is not achieved. If dilatation required within 6 months intervals and remain ineffective after 3 years, surgical intervention should be undertaken.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 Although repeated dilatation may result in significant complications. 7,8 Balloon dilatation has been considered the treatment of choice in cases of MS.…”

Section: Discussionmentioning

confidence: 99%

Congenital Esophageal Stenosis in an Infant

Singh¹,

Ansari²,

Gupta³

et al. 2014

jemds

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ABSTRACT:Congenital esophageal stenosis is a rare entity with a frequently delayed diagnosis. Patients are often treated according to diagnosis of GERD until intolerance to semisolid diet appears and CES is suspected. It usually presents in infancy and childhood. We are reporting a case of congenital esophageal stenosis in twenty-one days old male child. It is very rare to diagnose congenital esophageal stenosis at this age.

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Congenital Esophageal Pathology

Bruch

Coran

2018

Rickham's Neonatal Surgery

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Clinical characteristics of congenital esophageal stenosis distal to associated esophageal atresia

Cited by 55 publications

References 27 publications

Congenital esophageal stenosis associated with esophageal atresia: new concepts

Congenital esophageal stenosis associated with esophageal atresia: new concepts

Congenital Esophageal Stenosis in an Infant

Congenital Esophageal Pathology

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