Pediatric Service, University Hospital Hassan II, Fez, Morocco.
J Pediatr Gastroenterol Nutr. 2012 Jun;54(6):744-7. doi: 10.1097/MPG.0b013e31824b16b2.
Esophageal strictures in children are serious and require specialized care. Peptic stricture is most common in our context, whereas caustic and congenital strictures are rare. The present study reports our experience in esophageal endoscopic dilation while specifying the causes of esophageal strictures as well as their response to endoscopic treatment.
This is a case study during a period of 7 years, in which 60 cases of esophageal stricture were treated with endoscopic dilation by Savary-Gilliard bougies. Our patients were divided into 3 groups: group A for peptic strictures (52 patients), group B for caustic strictures (4 patients), and group C for strictures subsequent to esophageal atresia surgery (4 patients). The age of patients was between 10 months and 17 years. Dysphagia was the main symptom and was the major reason for consultation. Two hundred forty-seven dilation sessions were performed, with an average of 4 sessions per patient ranging from 1 to 15 sessions. The maximum score was observed in group B (50%). Expansion was performed under deep sedation.
We had 2 esophageal perforations: 1 in group A and 1 in group B. A good response was obtained in group A (70%) and B (50%). The patients in group C still required repeated sessions.
Esophagus endoscopic dilation is an effective technique, especially in peptic stricture, with no need of surgery in some cases. In addition, perforation was rare in this group.
儿童食管狭窄较为严重，需要专业护理。在我们的医疗环境中，最常见的是消化性狭窄，而腐蚀性和先天性狭窄则较为罕见。本研究报告了我们在食管内镜扩张方面的经验，并详细说明了食管狭窄的病因及其对内镜治疗的反应。
这是一项为期 7 年的病例研究，期间采用 Savary-Gilliard 探条对 60 例食管狭窄患者进行了内镜扩张治疗。我们的患者分为 3 组：A 组为消化性狭窄（52 例），B 组为腐蚀性狭窄（4 例），C 组为食管闭锁术后狭窄（4 例）。患者年龄在 10 个月至 17 岁之间。吞咽困难是主要症状，也是就诊的主要原因。共进行了 247 次扩张治疗，平均每位患者 4 次，范围为 1 至 15 次。B 组的最大评分（50%）最高。扩张在深度镇静下进行。
我们有 2 例食管穿孔：1 例在 A 组，1 例在 B 组。A 组（70%）和 B 组（50%）的反应良好。C 组的患者仍需要重复治疗。
食管内镜扩张是一种有效的技术，尤其是在消化性狭窄的情况下，在某些情况下无需手术。此外，该组穿孔的发生率较低。
