Esophageal dilatation

Abstract

Interventions for children with esophageal strictures have been performed since the Middle Ages. Fabricius ab Aquapendente first described instrumentation of the esophagus with tapered lengths of wax in the 16th century. The vast majority of affected children are affected by benign disease. Anastomotic stricture following esophageal atresia repair is one of the most common causes followed by gastroesophageal reflux disease and reflux-associated stricture. An esophageal contrast study may be helpful at the outset, particularly if fluoroscopy is not available for dilatation. Flexible endoscopic assessment is recommended, although rigid endoscopy also allows for direct visualization and remains a suitable alternative. General anesthesia with endotracheal tube intubation is the preferred method for children with an esophageal stricture. Esophageal stent insertion has a higher complication rate compared with dilatation alone. Stents are therefore reserved for children for whom more traditional methods have failed. Postoperative complications can be classified as early and delayed.