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At least 73 records · Page 4Linked to original sources
PubMed2003

[Surgical management of benign pharyngo-esophageal stenosis].

OBJECTIVE: To study the methods and outcome of surgical management for pharyngo-esophageal stenosis. METHODS: Twenty-seven patients with pharyngo-esophageal stenosis from January 1983 to June 2001 were reviewed. Among 27 cases, there were 12 cases accompanied with laryngeal stenosis and one case accompanied with tracheal stenosis. In terms of etiological factor, all patients were cataloged into two groups, i.e. 25 cases with chemo-causis and 2 cases with trauma. The repair methods included colon interposition in 20 patients, free jejunum transplantation in 6 patients and pectoralis major muculocutaneous flap in 1 patient. In total 12 cases of laryngeal stenosis, sternohyoid myofascial flap was applied in 8 cases, and sternohyoid myofascial flap and epiglottis were applied in 4 cases. RESULTS: Swallow function recovered in 25 cases and failed in 2 cases. Laryngeal function recovered totally in 10 patients and partially in 2 patients with laryngeal stenosis. The patient with tracheal stenosis recovered and decannulated. CONCLUSION: According to the foci of pharyngo-esophageal stenosis, the colon interposition, the free jejunum transplantation and the pectoralis major myocutaneous flap can be applied respectively to restore normal physiological function.

Adolescent↗
PubMed1999

Congenital esophageal stenosis.

We report 6 new cases of congenital esophageal stenosis (CES) that presented to us with special diagnostic and management problems and review the literature on this subject. Gastroesophageal reflux and achalasia are important differential diagnoses of esophageal stenosis, they may be associated with CES making appropriate management even more difficult. Treatment is also controversial, ranging from simple dilatation to segmental resection. CES should be present in every pediatric surgeon's mind should dysphagia occur on the introduction of semisolid food or esophageal food impaction, with a segmental stenosis demonstrated at esophagogram even when more obvious diagnoses are evoked.

Child↗
PubMedDate not supplied

[Congenital esophageal stenosis with submucosal fibrosis: report of one case].

Esophageal stenosis due to an intrinsic congenital factor is uncommon in infancy. We report a case of a male newborn infant, who was well at birth and presented with foamy sputum from the third day of life and vomiting at 18 days of age. Esophagogram revealed a narrowed segment, about 1 cm in length, at the level of the seventh and eighth cervical vertebral bodies, with proximal dilatation. There was no sign of gastroesophageal reflux. Operative findings: There was no external compression, foreign body or fistula, but a 1 cm length of esophageal stenosis was found. The stenosed segment was hard on palpation. Segmental resection of the stenosed region, with direct anastomosis of the esophagus was performed. Pathological examination of the narrowed segment revealed fibrosis of the submucosa without any tracheobronchial remnent components.

Esophageal Stenosis↗
PubMedDate not supplied

Congenital esophageal stenosis treated with endoscopic balloon dilation: report of one case.

Congenital esophageal stenosis is a narrowing of esophageal lumen that is present at birth, and may be asymptomatic in the neonate. Stenosis of the lower esophagus is a very rare form of esophageal obstruction. Three types of congenital esophageal stenosis have been described: fibromuscular stenosis, membranous webs, and tracheobronchial remnants. Fibromuscular stenosis and membranous webs respond to dilation, but must be distinguished from strictures caused by peptic esophagitis. Tracheobronchial remnants generally require surgical therapy. We report a 5-year-old girl with congenital esophageal stenosis, who presented with persistent dysphagia and poor weight gain. An esophagogram showed stricture of lower esophagus with proximal dilatation above esophagogastric junction. She was successfully treated with endoscopic balloon dilation.

Catheterization↗
PubMed2006

[Congenital esophageal stenosis due to tracheobronchial remnants: report of 2 cases and literature review].

Congenital esophageal stenosis due to tracheobronchial remnants is a rare malformation whose diagnosis may be difficult. It is characterised by the abnormal presence of congenital tissue of tracheal origin in the esophageal wall, which is responsible for the narrowing of the esophagus. We report 2 cases whose treatment was surgical after failure of esophageal dilations. The presence of tracheal-bronchial tissue was confirmed by histological examination of the operative piece. Outcome was favourable and the final result was excellent. Recently, endoscopic ultrasonography has been proved useful in the diagnosis of congenital esophageal stenosis due to tracheobronchial remnants by showing the presence of cartilage, which explains the failure of dilation. The high rate of perforation in these cases is due to brutal fragmentation of the cartilaginous rings. Surgical resection of esophageal stenosis with the tracheobronchial tissue appears the only treatment susceptible to completely suppress the stenosis and its consequences.

Bronchi↗
PubMed1996

[Intraluminal stent and balloon of intraluminal stent for prevention of esophageal stenosis due to alkali corrosive injury: experimental and clinical studies].

Experimental and clinical results of a intraluminal stent and ballon of intraluminal stent to prevent scar stenosis after esophageal corrosive injury. The model of Davis's esophageal corrosive injury was used. The dogs in group II III IV were killed at 7 weeks after injury. The smallest diameter of esophagus in group III and IV was significantly larger than that in group II (P < 0.01). The collagen content in group III and IV was significantly lower than that in group II (P < 0.01) and it was still lower in group IV than in group III (P < 0.05). Esophageal compoiance in group III and IV was significantly greater than that in group II (P < 0.01) and it was still greater in group IV than in group III (P < 0.05). The analyses of collagen images showed that the collagen density in group II (P < 0.01) was further lower IV than that in group III (P < 0.05). In 18 cases who were treated for prevention of stricture formation with an intraluminal stent 10 cases were completely recovered, 6 recovered after repeated dilations, and 2 failed. Furthermore, all 5 cases treated with mechanical pressure intraluminal stent were successful. It is suggested that intraluminal stent and mechanical pressure of intraluminal stent can alleviate the corrosive stenosis. But the balloon of intraluminal stent is still better than the intraluminal stent.

Adolescent↗
PubMed1999

Congenital esophageal stenosis: clinical and endoscopic features in adults.

BACKGROUND: Congenital esophageal stenosis (CES) is an uncommon anomaly that reportedly rarely goes undiagnosed until adulthood. One variant of CES includes patients with multiple cartilaginous rings described usually in the mid-distal esophagus. METHODS: Ten patients with CES seen over the past 7 years were interviewed and their clinical and endoscopic records reviewed. RESULTS: Eight patients were male and age at time of diagnosis ranged from 21 to 75 years. Meat impaction was the presenting symptom in 8 patients and 3 patients reported a relapsing history. Intermittent solid food dysphagia over extended duration (10-40 years) was reported in all patients with an estimated onset of symptoms at a mean age of 27 years (11-52 years). Endoscopically, all patients had segmental esophageal stenosis (length 2-8 cm, mean = 4.7 cm) due to 'trachea-like' multiple submucosal rings. Pseudodiverticulosis and distal reflux esophagitis were evident in 1 patient. Nine of 10 patients had no macroscopic esophagitis. Dilatation was performed by balloon insufflation (18 mm in 5 patients, 15 mm in 3 patients, 12 mm followed by 15 mm in a patient with a tight stricture) and by Savary dilators in 1 patient, without any complications. No patient had recurrent meat impaction on follow-up (1-7 years, mean = 3 years) after education about the condition. CONCLUSION: (1) We suspect CES is an under-recognized cause for intermittent, long-standing dysphagia in adults. (2) Food impaction is a frequent initial presentation. Recognition of CES is critical for appropriate patient education and planning.

Adult↗
PubMed2004

Circular myectomy for the treatment of congenital esophageal stenosis owing to tracheobronchial remnant.

The management of the congenital esophageal stenosis is not well established. The authors present an infant with critical esophageal stenosis owing to tracheobronchial remnant. This lesion was managed successfully by circular myectomy of the esophageal wall without resection. An 1-year-old girl was referred for recurrent vomiting and dysphagia. An esophagogram showed an abrupt stenosis, and endoscopic ultrasonography showed cartilaginous tracheobronchial remnants within the esophageal wall. The extirpation of muscular layer, which contained cartilage, was attempted. Circular muscular layer was resected in 1 cm width leaving mucosal layer intact. Muscular layer was closed horizontally with absorbable sutures. The patient is free from the symptoms and eats normally 1 year after surgery. In case of short segmental stenosis owing to tracheobronchial remnant, this may be the preferred approach.

Bronchi↗
PubMed1985

A case of congenital esophageal stenosis.

A case study of congenital esophageal stenosis is reported. Light microscopic examination revealed extensive disorganization of the inner circular muscle layer, with partial absence of the muscularis mucosae.

Esophageal Stenosis↗
PubMed1984

Dilation of esophageal stenosis by balloon catheter.

Treatment of esophageal stenosis by large diameter balloon catheters offers significant advantages over bouginage. Catheter dilating force is confined to the affected segment and can be controlled by the patient's reaction. Perforation is practically excluded by the use of fluoroscopy, contrast media, flexible angiographic guidewires, and better control over the time and forces of dilation. Wider, more lasting dilation can be achieved. Forty-one dilations were done on 21 patients with this new procedure without complications and with improved relapse-free intervals.

Adolescent↗
PubMed2001

Comparison of plastic prostheses and self-expandable metallic stents in the treatment of malignant esophageal stenosis.

OBJECTIVE: We compared the efficacy of plastic prostheses and self-expandable metallic stents in the treatment of malignant esophageal stenosis and/or fistula. SUBJECTS AND METHODS: Subjects were 31 patients with esophageal cancer, 4 with esophagotracheal fistula, and 1 with esophageal stenosis. A plastic prosthesis was inserted in 15 patients (group A) and a self-expandable metallic stent in 21 patients (group B). We evaluated food ingestion improvement, effectiveness, complications, mean survival, food ingestion duration, the percentage of food ingestion capability in total survival time, and inhospital mortality. RESULTS: No differences were seen in food intake improvement or in the effectiveness between groups, whereas fatal complications were higher in Group A. No significant differences were seen in mean survival, food ingestion duration, percentage of food ingestion capability, or inhospital mortality between groups. CONCLUSION: We concluded that a self-expandable metallic stent was safer than a plastic prosthesis because of fewer serious complications such as bleeding, and recommended the use of metallic stents in the treatment of malignant esophageal stenosis and/or fistula.

Aged↗
PubMed2004

[Congenital hiatus hernia associated with reflux esophageal stenosis].

A small group of three patients presented in our study represents extraordinary and very complicated problem of congenital hiatus hernia in infant period from 6th to 9th month of life, associated with gastroesophageal reflux and consecutive esophageal stenosis. There are two very rare and delicate entities within differential diagnosis, in the domain of the same pathology: congenitally short esophagus and congenital esophageal stenosis; with completely different surgical options for their treatment. That is why an optimal diagnostics and an adequate operative technique are extremely important for the treatment of hiatus hernia. The uppergastrointestinal barium radiography is definitely the method of diagnosing hiatus hernia, which provides typical, almost pathognomonic image of hiatus hernia accompanied by the esophageal stenosis. Nissen fundoplication is the technique of choice for its surgical treatment, with gastrostomy for probable postoperative esophageal dilatation. The results are more than satisfying: early peroral feeding, with spontaneous resolving of esophageal stenosis, which significantly diminishes the need for esophageal bougienage.

Esophageal Stenosis↗
PubMed2002

Adult case of squamous cell carcinoma arising on congenital esophageal stenosis due to fibromuscular hypertrophy.

This study relates to an adult case of squamous cell carcinoma arising on congenital esophageal stenosis. The patient was a 65-year-old man who had suffered from dysphagia and vomiting since birth and was diagnosed as having congenital esophageal stenosis. The patient had not received any treatment because his symptoms were mild. The patients suffered from severe dysphagia since he was 20 years old and had received balloon therapies several times; however, the effects were transient. After admission to our hospital, he underwent a transhiatal esophagectomy without thoracotomy. Histopathological examination of the resected specimen revealed a thick muscular mucosae associated with hypertrophic fibromuscular components and poorly to moderately differentiated squamous cell carcinoma in the region of stenosis. This case report is the first of a patient with squamous cell carcinoma arising on congenital esophageal stenosis.

Aged↗
PubMed2004

Congenital esophageal stenosis owing to ectopic tracheobronchial remnants.

BACKGROUND/PURPOSE: Congenital esophageal stenosis owing to tracheobronchial remnants (TBR) is a rare condition. Inappropriate treatment often is carried out before the correct diagnosis is established. For a better understanding and management of this disease, patients with TBR treated at our hospital and collected from the literature are reviewed to evaluate the course of onset, associated anomalies, methods of diagnosis and treatment, and outcomes. METHODS: Three patients treated at our hospital and 59 patients identified from the literature were included in the study. Gender, age at onset of symptoms, age at definitive treatment, esophagographic findings, pathology, methods of treatment, and outcomes of the 62 patients were recorded and analyzed. RESULTS: Boys slightly predominated (33:28, 1 unknown gender). Symptoms of dysphagia and regurgitation developed at the mean age of 3.2 +/- 4.5 months. Definitive treatment was carried out at the mean age of 2.6 +/- 3.0 years with a time lag of 2.0 +/- 2.5 years from the onset of symptoms. Twenty-five patients had associated anomalies with esophageal atresia being the most prevalent. Esophagography showed segmental stenosis over the distal third of the esophagus in all patients except one. The esophagographic findings could be classified into 3 types: type Ia, 10 cases; Ib, 15 cases; type II, 14 cases; type III, 3 cases. A nonyielding esophageal stenosis without inflammation was the characteristic esophagoscopic finding. Esophagoscopic dilatation of the stenosis was attempted in 26 patients, but all failed, and 2 patients suffered esophageal perforation. Surgical resection was mandatory for all patients to restore their esophageal continuity. Postoperative complications included anastomotic stenosis, anastomotic leakage, hiatal hernia, and gastroesophageal reflux. CONCLUSIONS: TBR should be suspected in patients who present with a typical history of dysphagia after ingestion of solid food and have characteristic esophagographic and esophagoscopic findings. It has a strong tendency to occur with esophageal atresia. Esophagoscopic dilatation is ineffective and may render the patient at risk for esophageal perforation. Operation is the treatment of choice and carries little morbidity and mortality.

Anastomosis, Surgical↗