Laparoscopic resection of esophageal stricture with transgastric stapled anastomosis in a child with AIDS.
A tight stricture in the lower esophageal stricture in a child poses significant surgical challenges. We report the first case of a laparoscopically assisted resection of a distal esophageal stricture in a 2-year-old girl with clinical AIDS (CDC stage 3). The patient presented with dysphagia, vomiting, and progressive weight loss. A barium swallow confirmed a distal tight esophageal stricture in the lower esophagus. After the second dilatation attempt failed a gastrostomy was inserted and highly active antiretroviral therapy treatment commenced. Follow-up contrast studies showed a nearly complete obstruction of the distal esophagus. A laparoscopically assisted resection of the esophageal stricture with a primary stapled anastomosis was performed with good results. At follow-up 8 months postoperative the child was tolerating feeds well and thriving.
Sidler
Daniel
D
Department of Paediatric Surgery, Tygerberg Children's Hospital, Stellenbosch University, Cape Town, South Africa. ds2@sun.ac.za
Salzmann
Gian M
GM
Juzi
Jonathan T
JT
Moore
Sam W
SW
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000714:Anastomosis, Surgical; D023241:Antiretroviral Therapy, Highly Active; D004940:Esophageal Stenosis / Q000601:surgery*; D005260:Female; D005774:Gastrostomy; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D017792:Surgical Stapling