PP15 ENDOSCOPIC INJURIES IN A PAEDIATRIC POPULATION: PERSONAL DECENNIAL EXPERIENCE

Abstract

scar stenosis was detected at the medium esophagus (lumen diameter 2 cm) that was dilated to 7 mm. At the second expansion it was evident, upstream of the stenosis, a peristenotic recess bounded by the esophageal lumen by a fibrous septum, communicating with it downstream, probably an outcome of the first pneumatic dilation. After radiological monitoring, a decision was made to pursue the achievement of a higher caliber of the esophageal lumen by further dilatation of the stricture prior to resection of the septum, in order 1) to facilitate the manoeuvres of endoscopic surgery, and 2) to obtain a stabilization of scar stenosis, reducing the chances of the septum constitution. Then we proceeded to delicate manoeuvres of endoscopic resection of the fibrous septum with a needle knife (microknife) in two stages: a first step with previous dilatation of the esophageal stenosis and partial resection of the septum, and a second step, to a distance of one month from the previous, with complete resection of the septal fibrous scar. The procedure, however delicate and risky, was complete and effective, allowing us to re-establish a regular esophageal channel. The following endoscopic control, performed 4 months after resection of the septum (delayed for family reasons and intercurrent illness of the patient), showed a good response to treatment, and a further esophageal dilatation was carried out to 10 mm.