Congenital Esophageal Stenosis Presenting During Weaning in a 5-Month-Old Infant

Congenital esophageal stenosis (CES) is a rare condition that may present with feeding difficulties in infancy, often becoming evident during weaning. We report a case of CES presenting with progressive dysphagia during the introduction of solid foods.

Clinical evaluation, contrast esophagography, endoscopy, and magnetic resonance imaging were performed to characterize the stenosis and guide management.

Imaging revealed a fixed narrowing of the mid-distal esophagus with minimal passage of contrast and proximal dilatation. Endoscopy confirmed a non-traversable intrinsic stenosis with macroscopically normal mucosa. The patient underwent three endoscopic dilation sessions under general anesthesia using Savary-Gilliard bougies with progressive diameters (3-5 mm, 3-7 mm, and 7-11 mm). No major procedural complications occurred. At 2-month follow-up after the last dilation, feeding was appropriate for age, dysphagia had improved, and growth was regular.

CES should be suspected in infants with feeding difficulties that worsen during weaning, particularly when symptoms are resistant to anti-reflux therapy. Endoscopic dilation can improve feeding tolerance, although repeated and staged sessions may be required. The role of adjunctive therapies such as topical budesonide remains uncertain.