The treatment of post-operative and peptic esophageal strictures after esophageal atresia repair. A program including dilatation with balloon catheters.
Nine patients, 6 weeks to 17 years of age with esophageal atresia (EA), developed esophageal strictures and were treated with 26 balloon catheter dilatations over a period of 3 years; 6 are now asymptomatic. Five of the 9 patients had suspected reflux esophagitis, confirmed in 3 by biopsy and treated medically prior to dilatation. Seven of the 9 patients had a primary anastomosis, 1 a gastric tube, and 1 a colonic interposition. Most dilatations in the group of 7 were performed with balloon (B) greater than or equal to the diameter of the distal esophagus (E) (B/E greater than or equal to 1). The 3 residually symptomatic patients include an infant dilated conservatively (B/E less than 1) to facilitate later bouginage, 1 patient with a recurrent stricture after stopping medical therapy and home bouginage, and 1 infant who had a persistent anastomotic stricture, suspected but untreated reflux esophagitis, and a perforation during the second balloon dilatation. Balloon catheter esophageal dilatation, as an alternative to bouginage, is usually a safe and effective procedure when reflux esophagitis is diagnosed and treated prior to dilatation.
Department of Radiology, Children's Hospital, Harvard Medical School, Boston.
F A
FA
Hoffer
H S
HS
Winter
K E
KE
Fellows
J
J
Folkman
D000293:Adolescent; D000714:Anastomosis, Surgical; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000637:transplantation; D004933:Esophageal Atresia / Q000601:surgery*; D004940:Esophageal Stenosis / Q000628:therapy*; D004942:Esophagitis, Peptic / Q000628:therapy*; D004947:Esophagus / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D011183:Postoperative Complications / Q000628:therapy*; D013270:Stomach / Q000601:surgery