[Esophageal dilatation in pediatrics: study of 33 patients].
BACKGROUND
Esophageal dilatation is usually regarded as an effective therapy in a majority of esophageal stenosis in childhood. However, the limited number of pediatric data does not allow definite conclusions on indications and complications of such a procedure.


METHODS
The files of 33 children whose esophageal stenosis had been treated by dilatation by the same operator between 1983 and 1992 were retrospectively reviewed. The structure mechanisms were: group 1: repair of esophageal atresia (n = 9), group 2: caustic esophagitis (n = 6), group 3: peptic esophagitis (n = 12), group 4: unclassified structures (congenital esophageal stenosis, achalasia) (n = 6). The dilatations were performed under general anesthesia, and the dilatator guide was introduced under endoscopic control. Two methods were used: Savary esophageal bougies and balloon dilatation. A thoracic X-ray was systematically performed after each dilatation.


RESULTS
One hundred and fourteen dilatations (3.5 dilatations/child) were performed (range: 1-32 dilatations). Twenty-five of the 33 children (76%) were dramatically improved after mechanical dilatation. Esophageal dilatation was unsuccessful in the eight other patients, seven of them requiring a surgical repair. Complications occurred in 3.4% of the dilatations: one esophageal perforation, one pneumomediastinum and two cardiac arrests (one of vagal origin and 1 after accidental extubation). All patients survived. Efficacy, duration of dilatation and complication rates were not similar in the four groups.


CONCLUSIONS
Esophageal dilatation should be considered as a simple and effective procedure when strict security rules are respected by a trained operator.
Huet
F
F
Service de gastroentérologie et nutrition pédiatrique, hôpital Robert-Debré, Paris, France.
Mougenot
J F
JF
Saleh
T
T
Vannerom
Y
Y
D000293:Adolescent; D000328:Adult; D002057:Burns, Chemical; D002648:Child; D002675:Child, Preschool; D004106:Dilatation / Q000379:methods* / Q000706:statistics & numerical data; D004933:Esophageal Atresia / Q000150:complications; D004940:Esophageal Stenosis / Q000139:chemically induced / Q000145:classification / Q000209:etiology / Q000628:therapy*; D004942:Esophagitis, Peptic / Q000150:complications; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies
Les dilatations oesophagiennes en pédiatrie: étude de 33 patients.