Characteristics and treatment of congenital esophageal stenosis: A retrospective collaborative study from three Japanese children's hospitals

Mochizuki, Kiyofumi; Yokoi, Akiko; Urushihara, Naoto; Yabe, Kiyoaki; Nakashima, Hiroaki; Kitagawa, Norihiko; Murakami, Kosaku; Fukumoto, Kouji; Sato, Masato

doi:10.1016/j.jpedsurg.2020.12.029

Cited by 5 publications

(12 citation statements)

References 13 publications

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“…The first treatment option is balloon dilatation. Perforation risk has been reported from 10% to 44% in balloon dilation [1,4,8,9] . Perforation usually occurs secondary to high pressure and prolonged dilatation.…”

Section: Discussionmentioning

confidence: 99%

“…There have been authors who argue that 60-95% of cases respond to dilatation regardless of histological type. In cases that do not respond to dilatation, surgery is recommended especially after two dilations [8,9] . Surgical resection and end-to-end anastomosis were performed in our patient, because there was no response with two dilatations and there was perforation.…”

Section: Discussionmentioning

confidence: 99%

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Multiple congenital esophageal stenosis: in a 14 month old girl

Yıldız¹

2022

Haydarpasa Numune Med J

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We aimed to share our very rare case with multiple congenital esophageal stenosis and its treatment. A 14-month-old girl presented with dysphagia, vomiting, and growth retardation, two esophageal strictures were detected in the esophagogram and esophagoscopic examination. While the proximal stenosis responded to balloon dilatation, the distal stenosis did not respond to dilatation and was perforated. Distal stenosis was treated with resection and anastomosis. Cases presenting with dysphagia and chronic vomiting should always be evaluated with esophagogram and endoscopy. Balloon dilatation should be the first choice in cases with stenosis. In cases that do not respond to dilatation, resection and anastomosis should be performed without insisting on dilatation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Multiple congenital esophageal stenosis: in a 14 month old girl

Yıldız¹

2022

Haydarpasa Numune Med J

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“…The former type is historically candidate for surgical resection, whereas the others for endoscopic for dilations [23] Although endoscopic ultrasonography may be useful in differential diagnosis [23,24], its accuracy is limited. Therefore, as highlighted in a large retrospective cohorts (83), dilation should be recommended as the initial therapy for patients with CES, reserving surgery for patients with persistent swallowing difficulties after dilation [25 ▪▪ ].…”

Section: Endoscopic Dilationsmentioning

confidence: 99%

New therapies for esophageal strictures in children

Angelino¹,

Tambucci²,

Torroni³

et al. 2021

Current Opinion in Pediatrics

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Purpose of review The present review aims at describing recent advances in therapeutic strategies for the treatment of benign esophageal strictures in children. We discuss current knowledge and practice on esophageal dilations, which are still the mainstream of treatment. We present new evidence about adjuvant treatments for recurrent and refractory strictures, including endoscopic incisional therapy, esophageal stenting, intralesional or topical mytomicin C and intralesional, systemic or topical steroids. Recent findings Current evidence on esophageal dilations is not sufficient to establish superiority of one of the available techniques, especially the use of balloon or bougie dilators, but a prospective international cohort study on anastomotic stricture in esophageal atresia is underway to address this issue. Recurrent and refractory strictures still represent a challenge, since none of the adjuvant pharmacological and mechanical interventions has shown to be enough feasible, effective and safe to revolutionize clinical practice. Summary In the last couple of years, several encouraging results have been published on management of esophageal strictures in children. Further research is needed, hopefully directed toward secure, easily reproducible and minimally invasive measures.

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“…Congenital esophageal stenosis (CES) is a rare malformation [ 1 – 6 ]. Almost all patients with CES are diagnosed and treated for esophageal stenosis during childhood [ 6 , 7 ], and they can achieve remission [ 1 ]. However, some patients develop protracted stenosis, even after treatment [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Here, we report our encounter of a case of esophageal cancer that developed in an adult with persistent CES. Although therapeutic outcomes and symptomatic surveillance after treatment for CES have been investigated in many studies [ 1 – 3 , 8 ], few have reported on long-term surveillance and the development of esophageal cancer. We report this case because it is extremely rare and has important implications.…”

Section: Introductionmentioning

confidence: 99%

Esophageal cancer in an adult with congenital esophageal stenosis: a case report

Fujiwara,

Kitagami,

Kikkawa

et al. 2024

surg case rep

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Background Congenital esophageal stenosis (CES) is a rare condition. We encountered a case of esophageal cancer that developed in an adult with persistent CES. Although many studies have investigated the therapeutic outcomes and performed surveillance for symptoms after treatment for CES, few have performed long-term surveillance or reported on the development of esophageal cancer. We report this case because it is extremely rare and has important implications. Case presentation A 45-year-old woman with worsening dysphagia was transferred to our hospital. The patient was diagnosed with CES at 5 years of age and underwent surgery at another hospital. The patient underwent esophageal dilatation for stenosis at 36 years of age. Esophagoscopy performed at our hospital revealed a circumferential ulcerated lesion and stenosis 15–29 cm from the incisors. Histological examination of the biopsy specimen revealed squamous cell carcinoma. Computed tomography (CT) revealed abnormal circumferential wall thickening in parts of the cervical and almost the entire thoracic esophagus. 18F-fluorodeoxyglucose-positron emission tomography-CT revealed increased uptake in the cervical and upper esophagus. No uptake was observed in the muscular layers of the middle or lower esophagus. Based on these findings, the patient was diagnosed with clinical stage IVB cervical and upper esophageal cancer (T3N1M1 [supraclavicular lymph nodes]). The patient underwent a total esophagectomy after neoadjuvant chemotherapy. The esophagus was markedly thickened and tightly adhered to the adjacent organs. Severe fibrosis was observed around the trachea. Marked thickening of the muscular layer was observed throughout the esophagus; histopathological examination revealed that this thickening was due to increased smooth muscle mass. No cartilage, bronchial epithelium, or glands were observed. The carcinoma extended from the cervical to the middle esophagus, oral to the stenotic region. Finally, we diagnosed the patient with esophageal cancer developing on CES of the fibromuscular thickening type. Conclusions Chronic mechanical and chemical irritations are believed to cause cancer of the upper esophagus oral to a persistent CES, suggesting the need for long-term surveillance that focuses on residual stenosis and cancer development in patients with CES.

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Characteristics and treatment of congenital esophageal stenosis: A retrospective collaborative study from three Japanese children's hospitals

Cited by 5 publications

References 13 publications

Multiple congenital esophageal stenosis: in a 14 month old girl

Multiple congenital esophageal stenosis: in a 14 month old girl

New therapies for esophageal strictures in children

Esophageal cancer in an adult with congenital esophageal stenosis: a case report

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