Dilation of Esophageal Strictures in Infants and Children: Single Institution Experience
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Date
2024-10-23
Authors
Netsanet Mengesha
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Publisher
Addis Ababa University
Abstract
Introduction: Esophageal strictures in childhood are typically benign and result from various factors like reflux esophagitis, caustic ingestions, and anastomotic scarring. Diagnosis is often by a barium esophagogram, with long strictures being over 2-3 cm. Initial management involves dilation using a balloon dilator or bougies, with dilation gradually expanding the stricture to prevent mucosal injury. Despite the extensive history of esophageal dilation practices in Ethiopia, there remains a notable gap in the literature regarding pediatric esophageal stricture dilation and its associated procedural outcomes.
Objective: To assess outcome of esophageal dilation of a stricture in children over the past 10 years at Tikur Anbessa Specialized Hospital.
Methodology: Quantitative retrospective descriptive case series in 13 patients who underwent esophageal dilation from April 1, 2014 to March 31, 2024. Result: Eight out of 13 patients (81% were male) had a median age of 2 years and 10 months, and all of them had dysphagia with the median duration of illness of 6 months. Twenty-three percent of them are equally caused by congenital, post-esophageal foreign body removal, and post-surgery . Sixty one percent (8/13) had a barium swallow at diagnosis. Of the 13(92%) had only single and short stricture. Forty percent of strictures occur in the distal portion of the esophagus. Three patients (23%) uneeded a gastrostomy before dilation.. Bougi dilation done with median of two times per patient. For most patients (69%), the follow-up period was less than six months. Complete response seen in 46% (6/13) of instances following a single dilatation session. Overall success rate was 69% (9/13).
Conclusion: The study examined esophageal strictures in children aged 1.5-12 years, with most having dysphagia. The majority had a single stricture, with the distal third being the most common site of stricture. Bougie dilation was the only treatment modality, with an overall response rate of 69%. The study suggests bougie dilation as a viable alternative for resource-limited settings.
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Keywords
DILATION OF ESOPHAGEAL STRICTURES