Diagnosis And Treatment Of Congenital Esophageal Stenosis

Background/PurposeCongenital esophageal stenosis (CES) is a rare malformation,Esophageal dilations and Surgical resection are the common treatment forCES. To explore the clinical situation and treatment of the CES in order toreduction the rate of misdiagnosis and early treatment.MethodsA retrospective study was carried out on55cases of CES（33patients：4patients abandon treatment） who accepted esophgeal dilatation oroperation from1990to2012, including clinical manifestation, diagnosis,treatment method, pathological findings.Results1. Only17（51%）cases were diagnosis correctly preoperative, the rateof misdiagnosis can reach49%for the first visited, even higher forTracheobrochial Remnants.(72%)Symptoms of dysphagia andregurgitation developed at the mean age of8.6, difinitive treatment wascarried out at the mean age of33.8with a time lag of almost2years fromthe onset of symptoms. 2. Clinicalmanifestation: vomiting after eating, regurgitation, failureto thrive, dysphagia, anaemia, hypersalivation, recurrent upper respiratorytract infection and pneumonia, food or foreign body inpaction.3. Dagnosis：The underlying dagnosis usually is made clear bymedical history, esophagogram and histopathologic examination of theresection segment. Esophagography was the primary diagnositic tool andwas perfrmed in all patients。4. Treatment: esophagoscopy or gastroscopy was performed in9patients.54dilations in29patients were performend,the mean number ofdilations for each patient was1.8,after a mean follow-up eriod of3years(range,1month to10years),26patients（79%） need operationfinally, so this dilation seems to be limited and critical. most patients’symptoms were dramatically relieved after resection of the stenoticsegment, postoperative complications included:anastomotic stenosis,anastomotic, gastroesophageal reflux after a mean follow-up period of3years (range,1month to10years). there was no death case in our study, sooperation is the treatment of choice and carries little morbidity andmortality.5.CES can be classified based on the histologic type of thestenosis:Tracheobronchial remnants (TBR)13cases; Fibromuscularhypertrophy or web (FMH)8cases.Conclusion CES should be suspected in patients who present with a typicalhistory of recurrent vomiting and dysphagia and have characteristicesophagographic findings. Dilation seems to be limited and critical, ifineffective, operation is the treatment of choice and carries little morbidityand mortality.