Tang Yun-Ping, Wei Xu-Xia, Xue Ning, Xu Jun-Jie
Department of Gastroenterology, Children's Hospital Affiliated to Shandong University/Jinan Children's Hospital, Jinan 250022, China (Xu J-J, Email: xjj6058@ 163. com).
Zhongguo Dang Dai Er Ke Za Zhi. 2024 Feb 15;26(2):169-173. doi: 10.7499/j.issn.1008-8830.2309045.
To investigate the endoscopic ultrasonography (EUS) features of benign esophageal stenosis in children.
A retrospective analysis was conducted on the medical data of the children who were diagnosed with benign esophageal stenosis from February 2019 to February 2022. The clinical manifestations, EUS findings, and treatment outcome were analyzed to summarize the EUS features of benign esophageal stenosis in children.
A total of 42 children with benign esophageal stenosis were included. Among these children, 19 (45%) had anastomotic stenosis after surgery for esophageal atresia, with unclear echogenic boundary of the esophageal walls and uneven thicknesses of the surrounding wall on EUS, and had 0-12 sessions of endoscopic treatment (average 2.1 sessions); 5 children (12%) had corrosive esophageal stenosis and 1 child (2%) had physical esophageal stenosis, with unclear stratification of the esophageal walls on EUS, and they had 2-9 sessions of endoscopic treatment (average 5.3 sessions); 1 child (2%) had patchy irregular hypoechoic areas of the esophageal walls on EUS and was diagnosed with tracheobronchial remnants with reference to pathology; 16 children (38%) had unexplained esophageal stenosis and unclear stratification of the esophageal walls on EUS, among whom 6 received endoscopic treatment. During follow-up, 95% (40/42) of the children had significant alleviation of the symptoms such as vomiting and dysphagia.
For benign esophageal stenosis in children, EUS can help to evaluate the degree of esophageal wall involvement in esophageal stenosis lesions, possible etiologies, and the relationship between the esophagus and the lesion and provide an important basis for selecting treatment modality and avoiding complications, thereby helping to optimize the treatment regimen.
探讨儿童良性食管狭窄的内镜超声(EUS)特征。
对2019年2月至2022年2月诊断为良性食管狭窄的儿童的医学资料进行回顾性分析。分析临床表现、EUS表现及治疗结果,总结儿童良性食管狭窄的EUS特征。
共纳入42例儿童良性食管狭窄患者。其中,19例(45%)为食管闭锁手术后吻合口狭窄,EUS显示食管壁回声边界不清,周围壁厚度不均,接受0 - 12次内镜治疗(平均2.1次);5例(12%)为腐蚀性食管狭窄,1例(2%)为物理性食管狭窄,EUS显示食管壁分层不清,接受2 - 9次内镜治疗(平均5.3次);1例(2%)EUS显示食管壁有斑片状不规则低回声区,病理诊断为气管支气管残余;16例(38%)为不明原因食管狭窄,EUS显示食管壁分层不清,其中6例接受内镜治疗。随访期间,95%(40/42)的患儿呕吐、吞咽困难等症状明显缓解。
对于儿童良性食管狭窄,EUS有助于评估食管狭窄病变累及食管壁的程度、可能的病因以及食管与病变的关系,为选择治疗方式和避免并发症提供重要依据,从而有助于优化治疗方案。