Makhoul I R, Shoshany G, Smolkin T, Epelman M, Sujov P
Department of Neonatology, Rambam Medical Center and Rappaport Faculty of Medicine, Technion, Bat-Galim 31096, Haifa, Israel.
Eur Radiol. 2001;11(5):867-9. doi: 10.1007/s003300000654.
Esophageal dilatation (ED) in neonates is rare. In the present case, ED was detected in a chest radiograph following repair of congenital diaphragmatic hernia (CDH) in a term neonate. A roentgenographic swallow study on the seventh day of life demonstrated ED and a sub-diaphragmatic stomach. The infant thrived adequately on enteral feeding. A swallow study on the twentieth day of life showed a normal-width esophagus with gastroesophageal reflux and small hiatus hernia. The longstanding herniated stomach in the fetus apparently caused kinking, edema, and obstruction of the gastroesophageal junction. This led to a significant ED and concealment of gastroesophageal reflux. We aim to arouse awareness about the occurrence of ED with CDH, and about its benign course under conservative management.
新生儿食管扩张(ED)较为罕见。在本病例中,一名足月儿在先天性膈疝(CDH)修复术后的胸部X光片中被检测出食管扩张。出生后第7天的X线吞钡造影检查显示食管扩张及膈下胃。该婴儿通过肠内喂养生长良好。出生后第20天的吞钡造影检查显示食管宽度正常,伴有胃食管反流和小的食管裂孔疝。胎儿期长期存在的疝入胃显然导致了胃食管交界处的扭结、水肿和梗阻。这导致了明显的食管扩张以及胃食管反流的隐匿。我们旨在提高对先天性膈疝合并食管扩张的认识,以及对其保守治疗下良性病程的认识。