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Congenital Esophageal Stenosis in Adults

  • Ashraf Ibrahim
  • Talal Al-Malki
Chapter

Abstract

There are few reports about congenital esophageal stenosis in adults. Patients may present with symptoms of non-cardiac esophageal chest pain, meat impaction and dysphagia due to trachea-like multiple submucosal rings as seen by endoscopy in the mid esophagus. CES is an under-recognized cause for long standing dysphagia in adults. CES in adults is more common in men. Radiographic and endoscopic examination show smooth concentric stricture or multiple rings similar to tracheal rings. Endoscopic ultrasonography shows focal circumferential hypoechoic wall thickening with disruption of the normal layer pattern corresponding to the areas of luminal narrowing. A double-contrast esophagogram reveals characteristic findings with multiple ring-like constrictions in the region of the stricture. Patients with mild forms of CES may present later in older children or even in adults with long standing non progressive dysphagia. Careful history taking may reveal recognized symptoms early in childhood. In adults TBR may respond to dilatations. Careful long term follow up of cases with CES is essential for fear of malignancy.

Keywords

Adult congenital esophageal stenosis Dysphagia Foreign body impaction Esophageal cartilaginous rings 

References

  1. 1.
    McNally PR, Lemon JC, Goff JS, Freeman SR. Congenital esophageal stenosis presenting as noncardiac, esophageal chest pain. Dig Dis Sci. 1993;38(2):369–73.  https://doi.org/10.1007/BF01307558.CrossRefPubMedGoogle Scholar
  2. 2.
    Younes Z, Johnson DA. Congenital esophageal stenosis: clinical and endoscopic features in adults. Dig Dis. 1999;17:172–7.  https://doi.org/10.1159/000016922.CrossRefPubMedGoogle Scholar
  3. 3.
    Katzka DA, Levine MS, Ginsberg GG, Hammod R, Katz PO, Insko EK, et al. Congenital stenosis in adults. Am J Gastroenterol. 2000;95:32–6.  https://doi.org/10.1111/j.1572-0241.2000.01668.x.CrossRefPubMedGoogle Scholar
  4. 4.
    Oh CH, Levine MS, Katazka DA, Rubesin SE, Pinheiro LW, Igor L. Congenital esophageal stenosis in adults: clinical and radiographic findings in seven patients. AJR. 2001;176:1179–82.  https://doi.org/10.2214/ajr.176.5.1761179.CrossRefPubMedGoogle Scholar
  5. 5.
    Ibrahim AHM, Bazeed MF, Jamil S, Hamad HA, Abdel Raheem IM, Ashraf I. Management of congenital esophageal stenosis associated with esophageal atresia and its impact on postoperative esophageal stricture. Ann Pediatr Surg. 2016;12:36–4.  https://doi.org/10.1097/01.XPS.0000482656.06000.84.CrossRefGoogle Scholar
  6. 6.
    Tabira Y, Yasunaga M, Sakaguchi T, Okuma T, Yamaguchi Y, Kuhara H, et al. Adult case of squamous cell carcinoma arising on congenital esophageal stenosis due to fibromuscular hypertrophy. Dis Esophagus. 2002;15(4):336–9.  https://doi.org/10.1046/j.1442-2050.2002.00270.x.CrossRefPubMedGoogle Scholar
  7. 7.
    Gonzalez A, Craft CM, Knight TT, Messerschmidt WH. Superimposed spontaneous esophageal perforation in congenital esophageal stenosis. Ann Thorac Surg. 2004;77:1098–100.  https://doi.org/10.1016/S0003-4975(03)00890-7.CrossRefPubMedGoogle Scholar
  8. 8.
    Rastogi R, Majid A, Singh VP, Joon P, Gupta Y. Congenital esophageal stenosis: a rare case of childhood dysphagia. J Gastrointest Dig Syst. 2016;6:1–3.  https://doi.org/10.4172/2161-069X.1000407.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ashraf Ibrahim
    • 1
  • Talal Al-Malki
    • 2
  1. 1.Consultant Pediatric SurgeonArmed Forces Hospital, Southern Region, King Fahad Military HospitalKhamis MushaitSaudi Arabia
  2. 2.Senior Consultant Pediatric and Neonatal SurgeonAlhada Military Hospital, Vice President for D&Q, Taif UniversityTaifSaudi Arabia

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