Pediatr Gastroenterol Hepatol Nutr.  2017 Jun;20(2):79-86. 10.5223/pghn.2017.20.2.79.

Clinical Study of Congenital Esophageal Stenosis: Comparison according to Association of Esophageal Atresia and Tracheoesophageal Fistula

• Kim SH
• Kim HY
• Jung SE
• Lee SC
• Park KW

• KMID: 2384820
• DOI: http://doi.org/10.5223/pghn.2017.20.2.79

Abstract

PURPOSE
Congenital esophageal atresia (CES) is a rare congenital disease. The severity of symptoms is variable; thus, diagnosis is difficult and tends to be delayed. CES is frequently accompanied by esophageal atresia (EA) with/without tracheoesophageal fistula (TEF). We investigated the characteristics of CES by reviewing our experience with CES patients and researched the differences between CES with EA-TEF and isolated CES.
METHODS
A total of 31 patients underwent operations for CES were reviewed retrospectively. The patients were divided into two groups according to the association with EA-TEF, and compared the differences.
RESULTS
Sixteen boys and 15 girls were included. The mean age at symptom onset was 8 months old, and the mean age at diagnosis was 21 months old. Nine patients with EA-TEF were included group A, whereas the other 22 patients were assigned to group B. There were no differences in sex, gestational age, associated anomalies and pathologic results between the groups. In group A, the age at diagnosis and age at surgery were younger than in group B despite the age at symptom occurrence being similar. Postoperative complications occurred only in group A.
CONCLUSION
In this study, symptoms occurred during the weaning period, and vomiting was the most frequent symptom. CES patients with EA-TEF tended to be diagnosed and treated earlier despite the age at symptom occurrence being similar. CES patients with EA-TEF had more postoperative complications; therefore, greater attention should be paid during the postoperative period.

Keyword

Congenital esophageal stenosis; Esophageal atresia; Tracheoesophageal fistula; Child

MeSH Terms

Child
Clinical Study*
Diagnosis
Esophageal Atresia*
Esophageal Stenosis*
Female
Gestational Age
Humans
Postoperative Complications
Postoperative Period
Retrospective Studies
Tracheoesophageal Fistula*
Vomiting
Weaning

Figure

• 

  Fig. 1 Esophagography of a patient with congenital esophageal stenosis. The site of stricture was found in the lower 3rd portion of the esophagus (arrowhead).

• 

  Fig. 2 Esophagography of a patient with double congenital esophageal stenosis. The sites of stricture were founded in the middle portion (arrow) and the lower 3rd portion of the esophagus (arrowhead).

• 

  Fig. 3 Esophagography of a patient who had esophageal atresia, congenital esophageal stenosis and achalasia simultaneously (black arrowhead: anastomosis site of esophageal atresia, black arrow: congenital esophageal stenosis, white arrowhead: site of achalasia).

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