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Diagnosis of CES

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Congenital Esophageal Stenosis

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Abstract

Symptoms of CES may begin acutely in the neonatal period. Leakage, recurrent TEF, respiratory problems, intolerance to feeds and failure to thrive may be a shadow for CES. Obtaining samples from the tips of the esophageal pouches during primary repair for histology may diagnose anastomotic CES. Failure to pass a size 6–8 French nasogastric tube to the stomach may clinch the diagnosis of CES during primary repair. A high index of suspicion during the initial esophagogram is required after EA repair to diagnose a distal CES. Most of the cases have delayed onset of symptoms. Progressive intolerance to feeds, dysphagia and foreign body impaction after the introduction of semisolid or solid food around the age of 6 months or more may be diagnostic. A barium study is the diagnostic and follow-up tool. Endoscopic ultrasonography (EUS) with miniprobes is useful to distinguish TBR with cartilage from FMD. Intra operative palpation, frozen section biopsy and the use of the flexible Esophagoscopy may be of help. Vascular rings are known causes of CES due to outside compression of the esophagus. These include double aortic arch, right aortic arch and pulmonary artery sling.

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Authors and Affiliations

  1. Consultant Pediatric Surgeon, Armed Forces Hospital, Southern Region, King Fahad Military Hospital, Khamis Mushait, Saudi Arabia

    Ashraf Ibrahim

  2. Senior Consultant Pediatric and Neonatal Surgeon, Alhada Military Hospital, Vice President for D&Q, Taif University, Taif, Saudi Arabia

    Talal Al-Malki

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  1. Ashraf Ibrahim
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  2. Talal Al-Malki
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Ibrahim, A., Al-Malki, T. (2019). Diagnosis of CES. In: Congenital Esophageal Stenosis. Springer, Cham. https://doi.org/10.1007/978-3-030-10782-6_5

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  • DOI: https://doi.org/10.1007/978-3-030-10782-6_5

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