Congenital stenosis of the esophagus due to tracheobronchial remnants: a missed diagnosis.
Lower esophageal strictures in infants in more than 90% of cases are related to reflux esophagitis, while the remainder are congenital or induced by injuries such as penetrating trauma or corrosion by caustic agents. Among congenital disorders cartilaginous remnants in the esophagus are very rare, but it is a possibility that should always be considered, especially if signs of esophagitis are not seen on esophagoscopy. The first aim, when evaluating the vomiting or regurgitating infant, is to establish whether this is due to an organic disorder. When stricture of the esophagus becomes evident following prolonged vomiting, clinicians tend to attribute this to reflux with peptic injury, and in most of the cases that will be correct (1). Carefully performed investigation will bring forth those rare etiologic factors that can be easily overlooked (2). The investigation has to include radiographic studies, esophagoscopy, pH monitoring, and in selected cases, manometry. Recognition of the correct etiologic factor that caused the stricture will pave the way for adequate management. We report on two patients with congenital stenosis of the lower esophagus due to cartilaginous rings, one of which was diagnosed preoperatively.
D001980:Bronchi; D002356:Cartilage; D002675:Child, Preschool; D002828:Choristoma / Q000175:diagnosis*; D003951:Diagnostic Errors; D004940:Esophageal Stenosis / Q000151:congenital* / Q000196:embryology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D014132:Trachea