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Postesophageal narrowing associated with Barrett esophagus
Insights
Pediatric gastro-esophageal reflux may be linked to distal obstructions causing mid-esophageal strictures and Barrett esophagus. Barium studies should extend to the duodenojejunal junction for better diagnosis.
Area of Science:
- Pediatric Gastroenterology
- Esophageal Pathology
- Gastrointestinal Motility Disorders
Background:
- Mid-esophageal strictures in children can be associated with gastro-esophageal reflux.
- Columnar epithelium-lined esophagus (Barrett esophagus) is a known complication of chronic gastro-esophageal reflux.
- Partially obstructing lesions distal to the esophagus are less commonly considered in this context.
Abstract:
Two children have been found to have partially obstructing lesions beyond the esophagus in association with mid-esophageal stricture. Both were found to have columnar epithelium-lined (Barrett) esophagus, and gastro-esophageal reflux. The more distal obstruction, in the pylorus and descending duodenum respectively, may have contributed to the development of the Barrett esophagus. It is recommended that any barium study of the esophagus which reveals an unexplained stricture should include visualization through the duodenojejunal junction as an aid to diagnosis, management, and understanding.