title: The radiological assessment of colonic replacement of the esophagus in children: A review of 43 cases.
abstract: OBJECTIVE
  To define the characteristic radiological features following colonic replacement of the esophagus in children.
  
  
  METHODS
  The upper gastro-intestinal contrast studies of 43 patients who underwent colonic replacement of the esophagus at our pediatric surgery unit were available for analysis. UGI contrast studies were performed routinely in the post-surgical period in 17 cases (first asymptomatic group), while the rest of contrast studies (26) belonged to a second group of out-patients complaining of dysphagia (18) or dyspepsia (8) following colonic replacement of the esophagus. Based on our observations, we proposed a grading system to describe the degree of colonic redundancy in the thorax.
  
  
  RESULTS
  Redundancy of the colonic conduit in the thoracic cavity was a common radiological finding (62.8%). The redundancy was mild (grade 1) in 18 patients, moderate (grade 2) in eight, and severe (grade 3) in only one patient. In 88.9%, the redundancy was in the right hemi-thorax. Patients presenting with postoperative dysphagia had a stricture at the site of the esophago-colic anastomosis in the neck, which should be differentiated from other sites of anatomical narrowing at the inlet and outlet of the thoracic cavity. Gastro-colic reflux was common among patients who underwent colonic replacement of the esophagus without an anti-reflux procedure.
  
  
  CONCLUSIONS
  Colonic replacement of the esophagus in children results in considerable anatomical alterations. Knowledge about the normal post-surgical changes and imaging features of the commonly encountered complications can increase the diagnostic confidence among radiologists and clinicians when dealing with these cases.
authors.affiliation: Faculty of medicine, Department of Pediatric Surgery, Ain Shams University, Abbasia, Cairo 11657, Egypt. Electronic address: amrabdelhamid@hotmail.com.
authors.forename: Amr Abdelhamid
authors.initials: AA
authors.lastname: AbouZeid
authors.affiliation: Faculty of medicine, Department of Radiodiagnosis, Ain-Shams University, Abbasia, Cairo 11657, Egypt. Electronic address: shaimaa96@hotmail.com.
authors.forename: Shaimaa Abdelsattar
authors.initials: SA
authors.lastname: Mohammad
authors.affiliation: Faculty of medicine, Department of Radiodiagnosis, Ain-Shams University, Abbasia, Cairo 11657, Egypt. Electronic address: leilarawash@gmail.com.
authors.forename: Leila Mohamed
authors.initials: LM
authors.lastname: Rawash
authors.affiliation: Faculty of medicine, Department of Pediatric Surgery, Ain Shams University, Abbasia, Cairo 11657, Egypt. Electronic address: ahmed_b_arafa@yahoo.com.
authors.forename: Ahmed Bassiouny
authors.initials: AB
authors.lastname: Radwan
authors.affiliation: Faculty of medicine, Department of Pediatric Surgery, Ain Shams University, Abbasia, Cairo 11657, Egypt. Electronic address: khaled80@hotmail.com.
authors.forename: Khaled M
authors.initials: KM
authors.lastname: El-Asmar
authors.affiliation: Faculty of medicine, Department of Pediatric Surgery, Ain Shams University, Abbasia, Cairo 11657, Egypt. Electronic address: ia_shaf@hotmail.com.
authors.forename: Ehab
authors.initials: E
authors.lastname: El-Shafei
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000000981:diagnostic imaging* / Q000601:surgery*; D003680:Deglutition Disorders / Q000000981:diagnostic imaging; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging; D004947:Esophagus / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011859:Radiography
keywords: Barium swallow; Colon bypass; Corrosive injuries; Esophagus; Pediatrics; Thoracic surgery