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[Treatment of peptic esophageal stenosis in childhood]
Insights
Peptic esophageal stenosis occurred in 17% of children with hiatal hernia. Early anatomical changes in infancy contribute to this condition. Fundoplication is the most effective treatment for reflux-related esophageal stenosis.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Esophageal Disorders
Background:
- Hiatal hernia and gastro-esophageal malposition are common in children.
- Peptic stenosis of the esophagus is a potential complication.
- Infantile anatomical and morphological changes of the cardia play a role in etiology.
Purpose of the Study:
- To evaluate the incidence of peptic esophageal stenosis in children treated for hiatal hernia.
- To analyze the etiological factors contributing to peptic esophageal stenosis.
- To determine the most effective therapeutic approach.
Main Methods:
- Retrospective analysis of 82 children treated for hiatal hernia and gastro-esophageal malposition.
- Evaluation of conservative and surgical treatment outcomes.
- Assessment of the time course from reflux symptoms to stenosis manifestation.
Main Results:
- 14 out of 82 children (17%) developed peptic esophageal stenosis.
- A short interval between initial reflux symptoms and stenosis was observed.
- Fundoplication, with or without bouginage, showed promising results.
Conclusions:
- Peptic esophageal stenosis is a significant concern in pediatric hiatal hernia cases.
- Infantile development of the cardia is crucial in the pathogenesis.
- Surgical intervention, specifically fundoplication, is the preferred treatment for this condition.
Abstract:
Among a total of 82 children treated conservatively and surgically for hiatal hernia and gastro-esophageal malposition (Lortat-Jacob) 14 cases (17%) of peptic stenosis of the esophagus was observed. In an evaluation of the etiology of peptic esophageal stenosis the importance of anatomical growth and morphological changes of the cardia during infancy is stressed. Analysis of patient data revealed an unusually short period of stenotic manifestation after the first symptoms of reflux had been noted. Fundoplication with or without bouginage on an endless string seems to constitute the most beneficial form of therapy.