[Esophageal stenosis with tracheo-bronchial heterotopy. Apropos of 3 cases]

Three cases of esophageal stenosis with tracheo-bronchial remnants within the wall of the esophagus, near the cardia, are reported: two girls and one boy; in three, this anomaly contains cartilage remnants. After various procedures, esophagoplasty was necessary when the boy of the first case was fourteen. Two girls was cured by a Thal procedure with follow-up of five and four years respectively. A survey of the references found 43 other cases. This anomaly is more frequent in girls. Tracheo-bronchial remnants are located usually in the esophagus near the cardia and contains cartilage. Rarely the respiratory inclusion is seen in the middle part of the esophagus and no cartilage is then identified. The stenotic segment is lined by squamous cell epithelium and the heterotopic tracheo-bronchial structures are intramural implants. The diagnosis should be suspected in cases of esophageal obstruction presenting in childhood or adult life with a history dating back to infancy or childhood. Radiologically a short stenotic non relaxing segment is the hallmark in the distal esophageal localisation. Resection of the stenotic segment with primary anastomosis is the method of choice in the middle part of the esophagus. That procedure is a good alternative in the distal esophagus.