The stenosis of esophagus, the reason of inability in ingestion
Medical History
Provided by: Dr. Sadeghipoor-e-Roudsari, Pediatric surgeon
Report of Radiology by: Dr. Seyyed Ali Alamdaran, Radiologist
Case I:
(AM) is an 11 months old boy who has referred for inability in ingestion of milk. He has vomited immediately after ingesting milk since 2 months ago. In this patient’s background, he has been operated because of Artesia of esophagus in 1-day old. He doesn't have any signs and problems of that until 9 months old.
Then his ingestion problems have been begun again.
Examinations:
In clinical examinations, fever, impatience, simulative cough and voice harshness were obvious. A child has relatively lower weight in term of age. Her/his weight is 7.500 (under percentile 5) and height is 78 cm on percentile 98. She/he is relatively faint, pale, thin and Low-active. In clinical examinations, there is not any other noticeable point.
One right thoracotomy scare that indicates one previous operation was observed.
Manage:
CXR was asked for AM that recognized normal lung and heart and two-sided. For more diagnosis views, barium swallow was asked for the patient and acute stenosis is done under esophagus copy that observed outside objects (including 2 cherry stones and 1 large gum) were removed. But her/his dysphasia existed longer so esophageal was asked again to observe stenosis. Its report is as follows:
«In provided barium swallow clichés, throat esophagus and superior thoracic were completely extended that terminates to acute sudden stenosis in place of anatomists, slight passing of was observed in delay cliché.»
Previous scare of patient is done under thoracotomy and the place of anastomosis of proximal esophagus was opened that one pistachio with shell (a foreign body) was up since dilation wasn’t possible because of acute stenosis, after opening; end to end anastomosis was done.
Conclusion:
All patients who have repairing background of artesian of esophagus are subject to stenosis of place of anatomists. Also one reason of their dysphasia can be existence of foreign body in that place. So its better that patients who are referring with dysphasia complaint after operation, are located under esophagus copy.
Since one reason of stenosis of place is anatomists of GER (GER), all patients should be followed up in the case of GER and if necessary, medical or serious therapy is done.
Dr. Sheikh Educational, Research and Treatment Hospital
