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      Estenosis esofágica congénita. La sospecha diagnóstica se inicia desde Atención Primaria Translated title: Esophageal congenital stenosis. The diagnostic suspect is started from Primary Care

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          Abstract

          Resumen La estenosis esofágica congénita es una malformación rara que ocurre debido a la separación incompleta del esófago y del sistema respiratorio. Generalmente cursa con vómitos persistentes que suelen debutar o exacerbarse con la introducción de la alimentación complementaria y con ello de los alimentos sólidos. Dados los síntomas de presentación, la sospecha diagnóstica se puede realizar desde las consultas de Pediatría de Atención Primaria. El diagnóstico se realiza mediante una endoscopia digestiva alta que mostrará normalidad de la mucosa y un tránsito digestivo. Existe controversia en cuanto al tratamiento de elección, prefiriéndose el tratamiento conservador mediante dilataciones endoscópicas de inicio.

          Translated abstract

          Abstract Esophageal congenital stenosis is an unusual type of malformation that occurs due to incomplete division of the esophagus and respiratory system. Generally, it shows up with persistent vomiting that tends to debut or exacerbate with the introduction of complementary feeding and solid foods. A high degree of suspicion is necessary for diagnosis from Primary Care pediatricians. A high digestive endoscopy with normal mucosa and a digestive transit confirm the diagnosis. There is controversy regarding the treatment of choice, conservative treatment is preferred by initial endoscopic dilations.

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          Most cited references4

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          ESPGHAN-NASPGHAN Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children With Esophageal Atresia-Tracheoesophageal Fistula.

          Esophageal atresia (EA) is one of the most common congenital digestive anomalies. With improvements in surgical techniques and intensive care treatments, the focus of care of these patients has shifted from mortality to morbidity and quality-of-life issues. These children face gastrointestinal (GI) problems not only in early childhood but also through adolescence and adulthood. There is, however, currently a lack of a systematic approach to the care of these patients. The GI working group of International Network on Esophageal Atresia comprises members from ESPGHAN/NASPGHAN and was charged with the task of developing uniform evidence-based guidelines for the management of GI complications in children with EA.
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            Endoscopic management of congenital esophageal stenosis.

            Congenital esophageal stenosis (CES) is a rare malformation. Endoscopic dilations represent a therapeutic option. This study retrospectively evaluated the efficacy and safety of a conservative treatment of CES. Patients diagnosed with CES since 1980 by a barium study or endoscopy were reviewed. Endoscopic ultrasonography (Olympus UM-3R-20-MHz radial miniprobe, Olympus Corporation, Tokyo, Japan), available from 2001, allowed for the differential diagnosis of tracheobronchial remnants (TBR) and fibromuscular hypertrophy (FMH) CES. All children underwent conservative treatment by endoscopic dilations (hydrostatic and Savary). Forty-seven patients (20 men) had CES. Fifteen were associated with esophageal atresia; and 8, with Down syndrome. Mean age at the diagnosis was 28.3 months (range, 1 day to 146 months). Symptoms were solid food refusal, regurgitation, vomiting, and dysphagia. Congenital esophageal stenosis was located in the distal esophagus. Endoscopic ultrasonography demonstrated TBR and FMH in 6 patients. One hundred forty-eight dilations in 47 patients were performed. The stenosis healed in 45 (95.7%). Complications were 5 (10.6%) esophageal perforations, hydrostatic (3/32, or 9.3%), and Savary (2/116, or 1.7%). At follow-up, 1 patient with FMH CES and 1 patient with TBR CES required operation for persistent dysphagia. The conservative treatment yielded positive outcomes in CES. Endoscopic ultrasonography allows for a correct diagnosis of TBR/FMH CES. A surgical approach should be reserved for CES not responsive to dilations. Copyright © 2011 Elsevier Inc. All rights reserved.
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              Esophageal duplication and congenital esophageal stenosis.

              Esophageal duplication and congenital esophageal stenosis (CES) may represent diseases with common embryologic etiologies, namely, faulty tracheoesophageal separation and differentiation. Here, we will re-enforce definitions for these diseases as well as review their embryology, diagnosis, and treatment.
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                Author and article information

                Journal
                pap
                Pediatría Atención Primaria
                Rev Pediatr Aten Primaria
                Asociación Española de Pediatría de Atención Primaria (Madrid, Madrid, Spain )
                1139-7632
                March 2020
                : 22
                : 85
                : 63-66
                Affiliations
                [4] Madrid orgnameHospital Universitario 12 de Octubre orgdiv1Servicio de Radiodiagnóstico Infantil España
                [3] Madrid orgnameHospital Universitario 12 de Octubre orgdiv1Servicio de Cirugía Pediátrica España
                [1] Madrid orgnameHospital Universitario 12 de Octubre orgdiv1Servicio de Pediatría España
                [2] Madrid orgnameHospital Universitario 12 de Octubre orgdiv1Servicio de Pediatría orgdiv2Sección de Gastroenterología, Hepatología y Nutrición Infantil España
                Article
                S1139-76322020000100015 S1139-7632(20)02208500015
                e5f4ca0f-b436-4017-9bf1-9a63f7e0c6c3

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 4, Pages: 4
                Product

                SciELO Spain

                Categories
                Casos clínicos en Digestivo

                Esophageal stenosis,Vomiting,Vómitos,Estenosis esofágica

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