title: Endoscopic management of congenital esophageal stenosis.
abstract: OBJECTIVE
  Congenital esophageal stenosis (CES) is a rare malformation. Endoscopic dilations represent a therapeutic option. This study retrospectively evaluated the efficacy and safety of a conservative treatment of CES.
  
  
  METHODS
  Patients diagnosed with CES since 1980 by a barium study or endoscopy were reviewed. Endoscopic ultrasonography (Olympus UM-3R-20-MHz radial miniprobe, Olympus Corporation, Tokyo, Japan), available from 2001, allowed for the differential diagnosis of tracheobronchial remnants (TBR) and fibromuscular hypertrophy (FMH) CES. All children underwent conservative treatment by endoscopic dilations (hydrostatic and Savary).
  
  
  RESULTS
  Forty-seven patients (20 men) had CES. Fifteen were associated with esophageal atresia; and 8, with Down syndrome. Mean age at the diagnosis was 28.3 months (range, 1 day to 146 months). Symptoms were solid food refusal, regurgitation, vomiting, and dysphagia. Congenital esophageal stenosis was located in the distal esophagus. Endoscopic ultrasonography demonstrated TBR and FMH in 6 patients. One hundred forty-eight dilations in 47 patients were performed. The stenosis healed in 45 (95.7%). Complications were 5 (10.6%) esophageal perforations, hydrostatic (3/32, or 9.3%), and Savary (2/116, or 1.7%). At follow-up, 1 patient with FMH CES and 1 patient with TBR CES required operation for persistent dysphagia.
  
  
  CONCLUSIONS
  The conservative treatment yielded positive outcomes in CES. Endoscopic ultrasonography allows for a correct diagnosis of TBR/FMH CES. A surgical approach should be reserved for CES not responsive to dilations.
authors: Digestive Surgery and Endoscopy Unit, 00165 Rome, Italy. erminia.romeo@gmail.com
authors: Erminia
authors: E
authors: Romeo
authors: Francesca
authors: F
authors: Foschia
authors: Paola
authors: P
authors: de Angelis
authors: Tamara
authors: T
authors: Caldaro
authors: Giovanni
authors: G
authors: Federici di Abriola
authors: Rosaalba
authors: R
authors: Gambitta
authors: Simona
authors: S
authors: Buoni
authors: Filippo
authors: F
authors: Torroni
authors: Valerio
authors: V
authors: Pardi
authors: Luigi
authors: L
authors: Dall'oglio