Summary
Unusual problems in oesophageal surgery in childhood include problems seen both frequently and infrequently. The former includes oesophageal atresia, peptic oesophagitis and corrosive oesophagitis; the latter includes such conditions as neonatal rupture of the oesophagus, explosive rupture of the oesophagus, achalasia of the cardia, pharyngo-oesophageal fibromatosis, nasogastric intubation stricture and stricture in the immunologically compromised patient. Examples of all of these conditions have been presented and reference has also been made to a wide variety of other conditions which have been reported in the literature. Because diagnostic delay is relatively common it is important for the paediatric surgeon carefully to evaluate the symptom of dysphagia when it is present and appreciate the fact that although organic disease in childhood is relatively uncommon there are many conditions which demand diagnosis and appropriate treatment.
Zusammenfassung
Sowohl bei häufigen als auch bei seltenen Erkrankungen gibt es in der Ösophaguschirurgie besondere Probleme. Die ersteren umfassen die Ösophagusatresie, peptische Ösophagitis und Ösophagusverätzungen, zu letzteren gehören Erkrankungen wie die explosive Ösophagusruptur, die Neugeborenenösophagusruptur, Kardiaachalasie, pharyngoösophageale Fibromatose, nasogastrische Intubationsstenose und Strikturen beim immunologisch gefährdeten Patienten. Beispiele aller dieser Erkrankungen werden präsentiert, und es wird Bezug genommen auf eine große Vielzahl anderer, über die in der Literatur berichtet wurde. Da es relativ häufig zu einer Verzögerung der Diagnose kommt, ist es für den Kinderchirurgen wichtig, das Symptom der eventuell auftretenden Dysphagie sorgfältig zu bewerten und die Tatsache zu berücksichtigen, daß es trotz relativer Seltenheit organischer Erkrankungen im Kindesalter viele pathologische Zustände gibt, die exakte Diagnostik und adäquate Behandlung erfordern.
Résumé
Les problèmes auxquels la chirurgie oesophagienne de l’enfant se voit confrontée sont autant le fait d’affections frequentes que d’affections plus rares. Parmi les affections fréquentes, citons I’atrésie oesophagienne, l’oesophagite peptique et I’oesophagite caustique et parmi les affections rares la rupture de l’oesophage du nouveau-né, la rupture explosive de l’oesophage, le cardiospasme, la fibromatose pharyngo-oesophagienne, la sténose naso-gastrique d’intubation et la sténose chez un patient dont les défenses immunologiques sont affaiblies. Les auteurs présentent des exemples de chacune de ces affections et se réfèrent à un grand nombre d’autres affections traitées dans la littérature. Vu qu’il arrive fréquemment que le diagnostic soit posé avec quelque retard, le chirurgien se doit d’évaluer avec soin le symptôme de dysphagie qui peut se présenter et tenir compte du fait que, bien que les affections organiques ne soient pas de régle chez les enfants, un grand nombre d’affections doivent être diagnostiquées et traitées.
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© 1991 Springer-Verlag Berlin Heidelberg
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Myers, N.A. (1991). Unusual Problems in Oesophageal Surgery in Childhood. In: Myers, N.A., Angerpointner, T.A. (eds) Paediatric Thoracic Surgery. Progress in Pediatric Surgery, vol 27. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-87767-4_11
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