Congenital esophageal stenosis: a rare case of dysphagia

Abstract

Congenital esophageal stenosis (CES) is a rare anomaly, resulting from incomplete separation of the respiratory tract from the primitive foregut at the 25th day of life. First clinical signs are abnormalities of the swallowing mechanism caused by the intrinsic narrowing of the esophagus. Diagnosis is usually delayed, requiring an accurate history and high level of suspicion, alongside with an esophagogram. Definite diagnosis is only confirmed by histological examination. Treatment usually involves surgery, depending on the severity, location and type of stenosis. We report the case of an 18 months old toddler diagnosed with CES. The characteristic radiographic and CT features are presented as well as the histology.

Esophageal stenosis: A case of delayed dysphagia in an infant from northern Tanzania

“…CES is a relatively rare entity with an incidence of 1 in 25,000 to 50,000 live births with a slight male predominence [1] . Depending on the severity of the stenosis, the age of presentation can be highly variable, with some being incidental findings during imaging in adulthood, while others have severe symptoms early on [4] .…”

“…Congenital esophageal stenosis (CES) is a rare pathology, and the diagnosis is usually delayed. The first clinical signs and symptoms are abnormalities in the swallowing mechanism caused by the intrinsic narrowing of the esophagus [1] . The challenges with feeding infants often lead to the symptoms being overlooked and diagnosis being delayed.…”

Use of transabdominal (external) ultrasound during balloon dilatation to diagnose tracheobronchial remnant in congenital esophageal stenosis

“…In TBR, there are commonly multiple echogenic regions within the muscle layer that represent aberrant cartilaginous remnants. The echogenicity and feature of the cartilage vary by report, including the following: a sonolucent area in the fourth layer,1 multiple low echoic regions in the focally thickened muscularis propria layer,5 thickened hypoechoic area made of cartilaginous material,7 hyperechoic lesions just underneath the mucosa and deep in the muscle layer,4 a complete hyperechoic ring outside the esophageal wall,3 hyperechoic lesions with acoustic shadow within the thickened segment,8 and little hyperechoic areas in the muscular layer 6. In the present case, we could observe the hypoechoic muscle layer with echogenic regions during TAUS.…”

High‐resolution manometry and endoscopic ultrasonography are important for diagnosing congenital esophageal stenosis

“…Typical CES treatments include general surgery and minimally invasive endoscopic surgery, depending on the severity, location and type of stenosis . Balloon expansion and myotomy are the most frequently utilized endoscopic treatments for CES.…”

“…Typical CES treatments include general surgery and minimally invasive endoscopic surgery, depending on the severity, location and type of stenosis. 8 Balloon expansion and myotomy are the most frequently utilized endoscopic treatments for CES. Resection of the esophageal segment is considered to be effective for the TBR and MD subtypes of CES, whereas dilation and myotomy are more suitable for FMS and MD subtypes.…”