Related Experiment Videos
[Dysphagia in children. Imaging]
M Elmaleh1, C Garel, M François
1Service de Radiologie, Hôpital Robert Debré, Paris.
Insights
Oesophageal obstructions cause regurgitation in infants and dysphagia in older children. Clinical evaluation, including ruling out infection and considering foreign body ingestion, guides diagnosis before simple imaging like X-rays and barium swallows.
Area of Science:
- Pediatric Gastroenterology
- Diagnostic Imaging
Background:
- Oesophageal obstructions present differently in neonates/infants (regurgitation, aspiration) versus older children (dysphagia).
- Clinical assessment is crucial to exclude buccopharyngeal infections before further investigation.
Purpose of the Study:
- To outline the diagnostic approach for oesophageal obstructions in children.
- To differentiate common causes from rarer oesophageal pathologies.
Main Methods:
- Clinical evaluation to rule out infection, foreign body ingestion, or caustic substance ingestion.
- Radiological investigations including chest X-ray and barium swallow.
Main Results:
- Dysphagia in older children warrants consideration of foreign body ingestion or cicatricial stenosis if fever is absent.
- Intrinsic (stenosis, fistulas, duplications) and extrinsic (vascular malformations, mediastinal tumors) lesions are less frequent causes.
- Simple radiological techniques are often sufficient for etiological diagnosis.
Conclusions:
- A systematic clinical and radiological approach effectively diagnoses paediatric oesophageal obstructions.
- Early identification of causes like foreign body ingestion is key to appropriate management.
Abstract:
While oesophageal obstacles are responsible for regurgitation or aspiration in neonates and infants, older children present with dysphagia. Before any investigation, a buccopharyngeal infection must first be eliminated clinically. In the absence of fever, the ingestion of a foreign body or caustic substances must be considered, either in an acute context, or in a chronic context related to cicatricial stenosis. Tumour or congenital lesions are less common, whether intrinsic (stenosis, fistulas, duplications), or extrinsic (vascular malformations, mediastinal tumours). Radiological investigation is based on simple techniques: chest X-ray and barium swallow are usually sufficient to establish the aetiological diagnosis.