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Oesophageal tracheobronchial remnants
S Nemolato1, G De Hertogh, P Van Eyken
1Dipartimento di Citomorfologia, Divisione di Anatomia Patologica, Università Degli Studi di Cagliari, Cagliari, Italy. gert.dehertogh@uz.kuleuven.ac.be
Insights
Congenital esophageal stenosis, a rare condition caused by tracheobronchial remnants, presents in infancy with feeding difficulties. Surgical resection offers effective treatment with low risks.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Developmental Biology
Background:
- Congenital esophageal stenosis is a rare condition originating from tracheobronchial remnants within the esophageal wall.
- Symptoms like dysphagia and regurgitation typically manifest in early infancy upon introduction of solid foods.
Observation:
- Clinical diagnosis is challenging, with conventional radiology showing esophageal dilation and delayed emptying.
- Endoscopy may reveal esophagitis-like lesions, but normal pH-metry necessitates further investigation.
Findings:
- The presence of tracheobronchial tissue in the esophageal wall is the hallmark of this condition.
- Histopathological examination of resected tissue confirms the diagnosis.
Implications:
- Early diagnosis and surgical resection of the stenosis are crucial for favorable outcomes.
- Understanding the role of tracheobronchial remnants aids in differentiating from other esophageal pathologies.
Summary:
Congenital oesophageal stenosis due to tracheobronchial remnants is a very rare condition characterized by the presence of tracheobronchial tissue in the oesophageal wall. The most common symptoms are dysphagia, regurgitation and hypersalivation. These usually appear in early infancy when solid food is introduced into the diet. Clinical diagnosis is difficult. Conventional radiology shows a dilated oesophagus without peristalsis, incomplete expansion of the gastro-oesophageal transition zone and delayed oesophageal emptying. Lesions suggesting oesophagitis may be present at endoscopy but pH-metry may be normal. The combination of stenosis with or without oesophagitis with normal pH-metry suggests that the patient's symptoms may be due to factors other than intraluminal and that further investigation is needed. The treatment of this condition requires surgical resection of the stenosis with little morbidity or mortality. The presence of tracheobronchial remnants is confirmed upon histopathological examination of the resected bowel segment.
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