Congenital esophageal stenosis associated with esophageal atresia/tracheoesophageal fistula: clinical and radiologic features. Yoo, H. J., Kim, W. S., Cheon, J., Yoo, S., Park, K., Jung, S., Shin, S., Kim, I., & Yeon, K. M. Pediatric Radiology, 40(8):1353–1359, August, 2010.
doi  abstract   bibtex   
BACKGROUND: Congenital esophageal stenosis (CES) can be associated with esophageal atresia/tracheoesophageal fistula (EA/TEF). Because there are a variety of degrees of obstruction and symptoms of CES, it is frequently difficult to make a pre- and post-operative diagnosis of the distal CES associated with EA/TEF. OBJECTIVE: To evaluate the clinical and radiologic features of congenital esophageal stenosis associated with esophageal atresia/tracheoesophageal fistula. MATERIALS AND METHODS: We retrospectively reviewed postoperative esophagograms and medical records of 187 children (107 boys, 80 girls) who had primary repair of EA/TEF from 1992 to 2009 at our institution. We evaluated the incidence of CES, clinical findings, radiologic features and management of CES in these children. RESULTS: CES was diagnosed in 22 of 187 EA/TEF children (12%); one child had double CES lesions, for a total of 23 lesions. Ten of those 22 children (45%) had presented with significant symptoms of esophageal obstruction. The diagnosis of CES was delayed in 10 children (45%) until 1-10 years of age. On esophagogram, CES (n = 23) was located in the distal esophagus (n = 20, 87%) or mid-esophagus (n = 3, 13%). The degree of stenosis was severe (n = 6, 26%), moderate (n = 10, 43%), or mild (n = 7, 30%). Eight children, including two with unsuccessful esophageal balloon dilatation of CES, were treated surgically. Histologic examination revealed tracheobronchial remnant (n = 7) or fibromuscular hyperplasia (n = 1). One child with surgically treated CES developed achalasia at the age of 3 years 9 months. CONCLUSION: Esophagography after EA/TEF repair should be performed with a high index of suspicion for the presence of distal CES, because the diagnosis and adequate management of CES can often be delayed.
@article{yoo_congenital_2010,
	title = {Congenital esophageal stenosis associated with esophageal atresia/tracheoesophageal fistula: clinical and radiologic features},
	volume = {40},
	issn = {1432-1998},
	shorttitle = {Congenital esophageal stenosis associated with esophageal atresia/tracheoesophageal fistula},
	doi = {10.1007/s00247-010-1603-0},
	abstract = {BACKGROUND: Congenital esophageal stenosis (CES) can be associated with esophageal atresia/tracheoesophageal fistula (EA/TEF). Because there are a variety of degrees of obstruction and symptoms of CES, it is frequently difficult to make a pre- and post-operative diagnosis of the distal CES associated with EA/TEF.
OBJECTIVE: To evaluate the clinical and radiologic features of congenital esophageal stenosis associated with esophageal atresia/tracheoesophageal fistula.
MATERIALS AND METHODS: We retrospectively reviewed postoperative esophagograms and medical records of 187 children (107 boys, 80 girls) who had primary repair of EA/TEF from 1992 to 2009 at our institution. We evaluated the incidence of CES, clinical findings, radiologic features and management of CES in these children.
RESULTS: CES was diagnosed in 22 of 187 EA/TEF children (12\%); one child had double CES lesions, for a total of 23 lesions. Ten of those 22 children (45\%) had presented with significant symptoms of esophageal obstruction. The diagnosis of CES was delayed in 10 children (45\%) until 1-10 years of age. On esophagogram, CES (n = 23) was located in the distal esophagus (n = 20, 87\%) or mid-esophagus (n = 3, 13\%). The degree of stenosis was severe (n = 6, 26\%), moderate (n = 10, 43\%), or mild (n = 7, 30\%). Eight children, including two with unsuccessful esophageal balloon dilatation of CES, were treated surgically. Histologic examination revealed tracheobronchial remnant (n = 7) or fibromuscular hyperplasia (n = 1). One child with surgically treated CES developed achalasia at the age of 3 years 9 months.
CONCLUSION: Esophagography after EA/TEF repair should be performed with a high index of suspicion for the presence of distal CES, because the diagnosis and adequate management of CES can often be delayed.},
	language = {eng},
	number = {8},
	journal = {Pediatric Radiology},
	author = {Yoo, Hye Jin and Kim, Woo Sun and Cheon, Jung-Eun and Yoo, So-Young and Park, Kwi-Won and Jung, Sung-Eun and Shin, Su-Mi and Kim, In-One and Yeon, Kyung Mo},
	month = aug,
	year = {2010},
	pmid = {20221592},
	keywords = {Child, Digestive System Abnormalities, Esophageal Atresia, Esophageal Stenosis, Female, Humans, Longitudinal Studies, Male, Radiography, Retrospective Studies, Treatment Outcome},
	pages = {1353--1359},
}

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