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At least 577 records · Page 32Linked to original sources
PubMed1978

[Assessment of a thirty year long experience in treatment of esophageal caustic stenosis (author's transl)].

Among 457 esophageal stenosis treated between 1954 and 1977, 258 (56%) were caustic stenosis. The treatment of those is the most difficult. Functionnal healding was satisfactory in 93% of the treated cases by dilatations. Four strict rules ought to be observed in the management of this cases. Immediate and long terme antibiotic treatment of the corrosive esophagitis. X rays are the only means to be used during evolution of corrosive esophagitis. No instrumental performance until sufficient cicatrization. Retrograde dilatations after gastrostomy shall be prefered in serious cases. Gastro-esophageal reflux may complicate this evolution and require surgery. Total esophageal replacement can be averted in most cases.

Anti-Bacterial Agents↗
PubMed2001

[Anastomotic stenosis after surgical treatment of esophageal atresia: frequency, risk factors and effectiveness of esophageal dilatations].

UNLABELLED: Anastomotic stricture is the most common complication following the surgical repair of esophageal atresia, and is usually treated by esophageal dilation. OBJECTIVES: The aims of this study were to assess in an infant population operated on at birth for type III or IV esophageal atresia: 1) the frequency of esophageal stenosis following the repair of esophageal atresia, and associated factors; 2) the efficacy of esophageal dilation by the Savary-Gaillard bougie technique. MATERIALS AND METHODS: The medical records of 52 children presenting with esophageal atresia over a 5-year period were retrospectively reviewed. Gestional age and birth weight, duration of mediastinal and transanastomotic drainage, and anastomotic complications including leakage, stricture, and the presence of gastroesophageal reflux were recorded and analysed. Patients presenting with anastomotic stricture were compared with a group of children without stricture. The number of esophageal dilations, their efficacy and the complication rate were analyzed. RESULTS: Anastomotic stricture developed in 20 (40%) of the 50 patients undergoing primary repair for esophageal atresia. The occurrence of anastomotic stricture was related to anastomotic tension during esophageal surgical repair (p < 0.03). Young children required esophageal dilation at a mean age of 142 days (24-930 days). Stricture resolution occurred after a mean of 3.2 dilations (1-15) over an average period of 7.9 months (range: 0-30 months). Dilation was successful in 90% of the 20 patients. Seven patients required only one dilation. Perforation of the esophagus occurred in one case, and this severe complication led to the death of the child. Esophageal dilation was unsuccessful in two patients, who presented prolonged severe dysphagia. CONCLUSION: Anastomotic stricture following repair of esophageal atresia is connected with the length of the gap that has to be repaired, and tension during suture. Esophageal dilation by the Savary-Gaillard bougie technique is an effective method for treating esophageal stricture. Several dilations are usually needed before the disappearance of dysphagia.

Age Factors↗
PubMed1991

[A case of corrosive esophagitis with stenosis].

A 41-year-old man was admitted to our hospital because of pharyngeal pain and vomiting after intentionally swallowing sodium hydroxide. Gradually esophageal stenosis took place. After 9 months from the taking poison the patient was operated. We tried blunt dissection of esophagus. But the procedure failed in because the wire of stripper was cut. So performed total esophageal resection under the right thoracotomy. The right side colon was used to re-construction through antero-sternal space that was anastmosed to cervical esophagus and stomach. The postoperative course was uneventful.

Adult↗
PubMed1996

[Eosinophilic esophagitis: an underdiagnosed entity?].

Eosinophilic esophagitis is an exceptional entity, although the number of published cases has increased three times during the last 3 years. We report the case of an 18-year-old male with a long esophageal stenosis due to eosinophilic esophagitis. Clinical, radiologic, endoscopic and manometric outcome was satisfactory after prednisone therapy. Although isolated esophageal involvement may occur, disseminated eosinophilic esophago-gastro-intestinal disease is more frequent. The disease is usually diagnosed in young male patients, presenting with dysphagia and, to a lesser extent, chest pain. Previous allergic conditions are reported in 80% of cases and peripheral eosinophilia is present in 80% of patients. Esophageal stenosis is present in 72% of cases and manometric alterations are found in 47% of patients. Radiographic findings are nonspecific and include stenosis and rigidity. Endoscopic features are not specific either, but diagnosis may be achieved by endoscopic biopsy. Corticosteroids and sodium chromoglycate have proved to be useful, with good therapeutic response being reported in 90% of patients with this underestimated disease.

Adolescent↗
PubMed1998

[Long-term follow-up of children with esophageal caustic stenosis].

BACKGROUND: Long term follow-up of children with esophageal caustic stenosis is not well known. The aim of the present study was to describe functional, organic and psychological, as well as social consequences. PATIENTS AND METHODS: Thirty-four children with a mean age of 3 years and 7 months +/- 3 years and 2 months (ranges: 1 month-14 years and 3 months) were included in a longitudinal study. Various parameters have been studied: treatment, functional symptoms, nutritional status (weight/height, body composition) and psychological and social consequences. chi 2 and Mann-Whitney tests were used for statistical analysis. RESULTS: Twenty-one patients have been treated by mechanical dilatations whereas surgery was performed in 12 children; the mean number of dilatations per child was higher in patients treated by dilatations (21 +/- 17 vs 14 +/- 16; P < 0.05). The frequency of dysphagia was not different in patients with colon interposition or not (69% vs 53%; P = 0.1). Nutritional status was not affected by the presence of esophageal caustic stenosis. Psychological and social consequences were characterized by scholastic difficulties, anxiety and severe depression. One case of suicide was observed. CONCLUSION: Children with caustic stenosis should be followed for a long period of time. A multidisciplinary approach is necessary, taking into account medical, social and psychological consequences.

Adolescent↗
PubMed1986

The significance of tracheal stenosis in esophageal atresia.

The significance of tracheal stenosis in children operated upon for esophageal atresia is described. Stenosis is caused mainly by tracheal compression by the innominate artery leading to tracheal malacia. Following esophageal repair tracheal compression is increased causing life-threatening asphyctic attacks during feeding. After establishment of diagnosis urgent surgery by means of truncopexy is indicated. The incidence of this complication is about 1 in 20 according to our figures and 1 in 40 according to Filler (Filler et al. 1976).

Esophageal Atresia↗
PubMed1999

[A treatment to serious esophageal cicatrices stenosi by metal and silica gel dilator].

OBJECTIVE: To find an effective method of treating the esophageal cicatricial stenosis. METHOD: Six cases with esophageal cicatricial stenosis were treated by mental and silica gel dilator. RESULT: The effects in all six cases were satisfactory and no any complications were finded. CONCLUSION: The method is safe, effective and of no complications, the treatment time is shorter also.

Adolescent↗
PubMed1982

Medical management of esophageal obstruction and esophageal-pulmonary fistula.

In patients with advanced esophageal stenosis, the quality of life is significantly effected. Nutrition and hydration are impaired, meals cause agony not pleasure, oral secretions cannot be swallowed properly, and pulmonary aspiration is common. Restoration of an adequate lumen will relieve the symptoms of esophageal stenosis. The goal of initial therapy is to establish and maintain a patent esophagus at the lowest risk and cost to the patient. Malignant esophageal stenosis safely may be dilated by the peroral route even in patients undergoing radiotherapy or with esophagopulmonary fistula. In those patients who fail to respond to esophageal dilation, surgery, or irradiation therapy for malignant esophageal stenosis, a peroral esophageal prosthesis may be placed under local anesthesia after proper esophageal dilation. The prosthesis is prepared for each patient based on the length of the esophageal stenosis. The procedure requires less than one minute to perform. The patient has no foreign body sensation and is able to swallow a soft-to-regular diet for the remainder of his life. This method may also be used to occlude esophagopulmonary fistulae caused by malignancy. The quality and duration of life both are significantly improved by use of the peroral prosthesis in patients with malignant esophageal obstruction. Nutrition support by nasoenteric or jejunostomy tube should be used when needed to restore nitrogen balance and immune competence.

Bronchial Fistula↗