title: Peptic oesophageal stricture in children: management problems.
abstract: BACKGROUND
  Peptic oesophageal stricture (PES) is a serious complication of gastroesophageal reflux disease (GERD) in childhood. The treatment of PES is still controversial, ranging from simple oesophageal dilations to resection/anastomosis of the stenotic portion of the oesophagus. In this study, we want to share our experience with 11 children with GERD and PES.
  
  
  METHODS
  A retrospective review of clinical data obtained from children who underwent dilation and antireflux surgery for PES was performed.
  
  
  RESULTS
  A total of 11 patients were diagnosed with PES. The clinical picture was dominated by dysphagia. Barium swallow showed hiatal hernia in nine cases (82%). Oesophageal strictures were located most commonly in the lower third of the oesophagus (91%). Three Children (27%) with PES had a neurologic impairment and patients had a mean duration of symptoms of 20 months (range, 3 month to 6.2 years) before intervention. Children received a median of four dilations (range, 1-21 dilations) for PES. Time to first dilation from age of diagnosis was a mean of 4.5 months (range, 2-14 months). Antireflux surgery was performed in all patients. Post-operatively, seven patients required repeat oesophageal dilation. Patients were followed with serial dilation for a median of 6 years (range, 1-9 years) and only one patient has a continued requirement of oesophageal dilation for PES.
  
  
  CONCLUSIONS
  GERD complicated by PES is an important condition affecting a significant number of children. Early and effective treatment of both stricture and GERD is required to improve the prognosis of this serious condition.
authors.affiliation: Department of Pediatric Surgery, Habib Thameur Hospital, Tunis, Tunisia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Zouari
authors.forename: Houda
authors.initials: H
authors.lastname: Kamoun
authors.forename: Habib
authors.initials: H
authors.lastname: Bouthour
authors.forename: Rabia
authors.initials: R
authors.lastname: Ben Abdallah
authors.forename: Youssef
authors.initials: Y
authors.lastname: Hlel
authors.forename: Riath
authors.initials: R
authors.lastname: Ben Malek
authors.forename: Youssef
authors.initials: Y
authors.lastname: Gharbi
authors.forename: Nejib
authors.initials: N
authors.lastname: Kaabar
mesh_terms: D002675:Child, Preschool; D004106:Dilatation / Q000379:methods*; D004940:Esophageal Stenosis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome