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At least 91 records · Page 5Linked to original sources
PubMed1981

Congenital esophageal stenosis due to tracheobronchial remnants and its associated anomalies.

Two cases of congenital esophageal stenosis due to tracheobronchial remnants are reported, one accompanied by anovestibular fistula and the other by microphthalmos with iris coloboma. A survey of congenital esophageal stenosis due to tracheobronchial remnants in Japan revealed that the incidence of associated anomalies in this lesion is 17.3% This value is significantly lower than that reported for esophageal atresia. Our analysis showed that esophageal atresia is the most frequently associated anomaly, followed by anorectal abnormalities. Cardiovascular anomalies are very uncommon. Embryology relating to this subject is discussed.

Bronchi↗
PubMed1988

Balloon dilatation of esophageal stenosis in children.

Balloon dilatation of benign esophageal strictures is an accepted mode of therapy in adults. This report describes balloon dilatation in 20 consecutive infants and children. The lesions treated include 11 strictures at surgical anastomotic sites, seven restrictive Nissen fundoplications, and three nonanastomotic esophageal strictures. One patient had two lesions. Most dilatations were performed on an outpatient basis without anesthesia. All strictures responded immediately to dilatation. In most cases, long-term resolution occurred after three or fewer procedures. A subgroup of patients was identified in which a prolonged course of treatment was needed. These included patients with long strictures due to esophageal atresia, patients with chronic severe esophagitis, and patients with strictures at the site of esophageal perforation. No significant complications were encountered. Balloon dilatation of esophageal stenosis in children is effective and safe and should be considered before other methods of treatment are used.

Catheterization↗
PubMedDate not supplied

Repair of a high esophageal stenosis with a mucosal flap of a Zenker's diverticle.

A patient presented an esophageal stenosis due to lasertherapy by Dohlmann's technique for the treatment of a Zenker's diverticle. This esophageal stenosis has been repaired by taking a mucosal flap out of the Zenker's diverticle. The technique is presented in this paper, together with some analogue data from literature.

Diverticulum, Esophageal↗
PubMed1980

[Esophageal stenosis in sjögren's syndrome].

Dysphagia in Sjögren's syndrome may be caused by xerostomy, pharyngoesophagitis and esophageal membranes. This is the first report on a tubular upper esophageal stenosis in a 71 year old woman with Sjögren's syndrome who developed progressive dysphagia. It is suggested, that this stenosis was due to chronic inflammatory processes and secondary sclerosis of deep layers in the esophageal wall. Bouginage was adequate symptomatic therapy. Tubular esophageal stenosis is regarded as gastrointestinal manifestation of Sjögren's syndrome.

Aged↗
PubMed2006

Effective esophageal balloon dilation for esophageal stenosis in recessive dystrophic epidermolysis bullosa.

Recessive dystrophic epidermolysis bullosa (RDEB) is an inherited disorder of squamous epithelium that results in dystrophic scarring of the skin after minor trauma. RDEB is classified into two subtypes: Hallopeau-Siemens (HS) and non-Hallopeau-Siemens (nHS). Although severe scarring of the skin is the most common and obvious complication of the disease, esophageal scarring with formation of long strictures may also develop. Treatment options for esophageal stenosis in patients with RDEB include steroids, hyperalimentation, esophageal dilation and replacement. This report describes a child who was dilated immediately after diagnosis of severe esophageal stenosis subsequent to nHS-RDEB and managed successfully. Endoscopic esophageal balloon dilation under fluoroscopic control was very useful for detecting the region of stenosis and bougienage. The literature on such injuries is reviewed here, and the problems associated with the treatment of children with esophageal stenosis associated with RDEB are discussed.

Catheterization↗
PubMedDate not supplied

Chevalier Jackson Lecture. Esophageal stenosis in children.

Congenital anomalies that can produce esophageal stenosis as well as acquired diseases of the esophagus in children are described. The infant and child who refuse to accept solid foods must be submitted to roentgenologic and endoscopic examination. Dysphagia is sometimes difficult to recognize in infants and children. Endoscopic treatment alone or associated with surgery is successful in many cases if well indicated and precisely done.

Bronchi↗
PubMedDate not supplied

[ESOPHAGEAL STENOSIS IN CHILDREN: MEDICAL TREATMENT EXPERIENCE]

We present a retrospective evaluation of our experience in the period that goes from January 1992 to December 1998, clinical records of 58 patients ages from 2 months old to 15 years, male and female, who were treated at the GI service of Instituto de Salud del Ni o, were reviewed. All of them had esophageal stenosis and were included in the Esophageal Dilatation Program with Savary-Gilliard bougies. The causes of Esophageal Stenosis in the study were: Caustic agents 37.9%, gastro esophageal reflux (GER) 20.7%, surgery sequela 19.0%, related to esophageal esclerotherapy 12.1%, foreign body itself or maneuvers to retrieve them 8.6%, stomach adenocarcinoma invading the esophagus. Patients were classified in three groups: Group 1: stenosis due to caustic agents Group 2: stenosis due to GER Group 3: The remaining causes mentioned above., In each the following was calculated: the arithmetical media, the range of dilatations sessions and the total number of them. The higher figures took place in group 1. So we conclude that the number of sessions is directly related with the cause of the stenosis, requiring more number of dilatations to get a better response. Finally the response to treatment is evaluated considering a good response in 72.4%. A mild response in 15.5% and therapeutic failure in 12.1% of patients. The rate of complications was 10.3 per patient and 1.1 in relation to the total number of dilatation sessions. The main complications were: gastric perforation, duodenal perforation, pneumomediastinum, esophago-tracheal fistulae andi pseudodiverticulum formation, with resolution as seen in posterior controls. These complications occured after the proceeding took place. The treatment was installed according to each case. The patients with duodenal perforation died. We conclude that esophageal dilatations in infants with esophageal stenosis, of different ethiology, are secure and efficient.

Journal Article↗
PubMed1993

[Parenteral replacement of 1-T4 in hypothyroid patients with esophageal stenosis and unconsciousness].

Hypothyroid patients are usually treated with in an oral administration of 1-T4. When oral administration is impossible because of esophageal stenosis or unconsciousness in such patients, parenteral replacement is required. We prepared a solution of 1-T4 50 micrograms/ml for intravenous administration in Tohoku University Hospital as follows: 5mg of 1-T4 (Nakarai Co.) was dissolved in 1ml of 0.1N NaOH and diluted with 0.9% NaCl and sterilized with membrane filter. Two patients with esophageal stenosis due to thyroid cancer and esophageal cancer and one in a coma due to adrenal crisis had replacement with intravenous 1-T4. Initial doses of 12.5 micrograms or 25 micrograms diluted with 100ml of 0.9% NaCl containing 1% albumin were given by drip infusion. Every week 12.5 micrograms or 25 micrograms of 1-T4 was increased. By replacement of low doses, 50 micrograms or 75 micrograms, serum T4 reached a normal level. No adverse action was observed during or after parenteral replacement. The preparation of 1-T4 was stable at least for one year and 11 months. Parenteral replacement of T4 is a useful and safe method for patients who are unable to take drugs orally.

Aged↗
PubMed2002

Usefulness of endoscopic ultrasonography in the diagnosis of congenital esophageal stenosis.

BACKGROUND/PURPOSE: Endoscopic ultrasonography (EUS) is considered a potentially useful tool to investigate structural abnormalities of the esophagus in pediatric patients, as in adults. The aim of this study was to evaluate the usefulness of EUS for the diagnosis of congenital esophageal stenosis. METHODS: High-frequency catheter probe EUS was performed under general anesthesia in 2 patients who had congenital esophageal stenosis. RESULTS: A 4-year-old boy with anorectal anomaly showed tapered narrowing in the distal esophagus, which was not ameliorated with balloon dilatation. High-frequency catheter probe EUS showed hypertrophy of the muscular layer in the esophageal wall at the narrowed portion, but no images suggested the presence of tracheobronchial remnants. The histologic diagnosis of fibromuscular hypertrophy was confirmed at esophagoplasty. A 5-month-old boy with Gross C-type esophageal atresia and symptomatic gastroesophageal reflux showed tapered narrowing in the middle esophagus on esophagography. The symptoms of stenosis were not ameliorated by balloon dilatation performed 4 times. High-frequency catheter probe EUS showed hyperechoic lesions suggesting cartilage at the esophageal narrowing. The diagnosis of tracheobronchial remnants was confirmed by the finding of 2 pieces of cartilage in the specimen obtained at the time of esophageal resection. CONCLUSION: EUS can be applied to show structural abnormalities of the esophageal wall even in pediatric patients with congenital esophageal stenosis and is useful for planning the therapeutic strategy.

Child, Preschool↗
PubMedDate not supplied

[Efficacy of sorption therapy in patients with cicatricial esophageal stenosis].

We examined 110 patients treated conservatively for cicatricial esophageal stenosis including expansion on the string. The patients were divided into three groups: controls (n = 35), receiving adjuvant SUMS-1 (n = 38) and given adjuvant enterosgel (n = 37). According to electron microscopy, enterosorbents make esophageal mucosa denser by decreasing interstitial spaces as a result of microcirculatory improvement and reduction of edema. Enterosorbents elevate total protein and sugar in the blood.

Blood Glucose↗
PubMed1992

[Esophageal bypass operation of a patient with esophageal stenosis and esophago-bronchial fistula due to lung cancer].

Esophageal bypass operation was carried out for a patient with lung cancer who was not able to take oral feeding, due to esophageal stenosis and esophago-bronchial fistula. Stomach was used as a esophageal substitute, through antethoracal route. Abdominal esophago-jejunostomy was performed for drainage of esophago-bronchial fistula. Oral intake of foods was started from 11th postoperative day without major complication. And then, she was permitted to discharge only with a jejunostomal feeding tube. Recently the quality of life is emphasized, even in cases in which curativity of cancer cannot be expected. Surgery in such cases entails many risks and then, special care must be taken to determine the indication and procedure of this operation. In the case herein reported, such attention to detail resulted in survival for over one year.

Aged↗
PubMed1987

Congenital esophageal stenosis due to tracheobronchial cartilage.

Six cases of lower esophageal stenosis due to tracheo-bronchial remnants are reported. The symptoms become apparent after weaning. Esophagography and esophagoscopy are the essential means for diagnosis. The treatment includes resections of the stenotic segment and an end-to-end anastomosis.

Bronchi↗
PubMed2003

Results of a new technique in the treatment of severe esophageal stenosis in children: poliflex stents.

OBJECTIVES: The authors present their experience in treating cases of severe esophageal stenosis resistant to conventional dilatation through the placement of silicone stents, describe a precise placement technique, and establish a standard protocol for the use of these devices. METHODS: The authors detail the placement procedure and follow-up in a series of 10 patients (5 male, 5 female) between 1 and 23 years, in whom the technique was used. Nine patients had severe esophageal scarring caused by alkaline agents, and another had severe stenosis resulting from esophageal atresia; all were included in the dilatation program from the age of 6 months to 19 years. The method employs a self-expanding biocompatible stent that is placed using a special applicator over the stenotic area after performing a dilatation. This is maintained long enough to guarantee esophageal scarring without stenosis, permitting oral feeding of the patient. In general, the children experienced nausea and some vomiting during periods lasting from 12 to 48 hours; these episodes were more common when the lesion was higher and longer. Treatment with midazolam and ondansetron relieved the symptoms. All patients received omeprazole while the stent was in place. RESULTS: Five patients received one stent, four others required two, and another needed three because of restenosis. In the five patients who required stent replacement, a low dose of steroids (0.3 mg/kg/24 h) was administered 2 weeks before and also during the placement time. Currently, five patients are completely cured, with follow-up ranging from 4 to 19 months. Three patients now require stent replacement, and two others are under observation after having the stent removed. Long-term tolerance to the stent has been excellent in all cases. The time the stent was in place varied from 20 to 133 days. CONCLUSIONS: The siliconated polypropylene stents (Poliflex/Rüsch) appear to be a promising new tool in the conservative treatment of esophageal stenosis. The stents permit normal feeding during application, substantially reduce treatment time, and avoid repeated anesthesia sessions for dilatations.

Adolescent↗