Congenital Esophageal Stenosis with Long Term Follow Up: Report of a Case

先天性食道狹窄長期追蹤：病例報告

陳政隆(Cheng-Lung Chen) ； 江榮華(Zung-Hwa Chiang) ； 周定遠(Ting-Ywan Chow)

《Formosan Journal of Surgery》 40卷6期 (2007/12) Pp. 265-270

https://doi.org/10.29833/FJS.200712.0007

摘要

一位足月出生女嬰只能慢慢餵食半奶，快速餵食會引起反嘔及噎食。當六個月大開始餵食固體食物時，立刻反嘔，吐出已吞的食物，因此只能吞食流質食物。四歲時，食道攝影顯示食道中段部分狹窄。病人在六歲，體重只有十五公斤，才接受外科治療。首先試圖使用通條擴張食道失敗後，以手術切除狹窄段，再端端吻合兩斷端。病人手術後可吞食固體物。病理檢查切除之食道顯示：長1.6公分、外徑1.2公分、內徑0.2公分、黏膜正常、黏膜下肌肉層增生、肥大、排列紊亂、軟組織廣泛性纖維化，診斷爲先天性纖維肌肉狹窄。術後病人發育成長正常。青春期以後，吞食大塊肉類時稍有遲滯感覺。食道鏡檢查及食道攝影顯示吻合處疤痕形成輕度狹窄。她未接受進一步的處置，只是避免吞嚥大塊肉類。

並列摘要

Congenital esophageal stenosis is a rare entity, its incidence is much lower than that of congenital esophageal atresia. We report a full term normally delivered female infant who could only be fed with milk slowly after birth. Rapid feeding caused choking and regurgitation. She could tolerate liquid diet only. Esophagography at 4 years of age showed a short segmental stenosis at middle esophagus. The patient underwent surgical intervention at age 6 when her body weight was only 15 kilograms. Segmental resection of stenosis with primary end-to-end anastomosis was done after failure to dilate with a bougie. Pathological examination of the resected specimen showed congenital fibromuscular stenosis. After the operation the patient could eat solid foods and gained weight normally. As a teenager, she began to experience mild stasis in swallowing large pieces of meat. Both esophagoscopy and esophagography 18 years after operation showed a mild ringed narrowing at the anastomotic site. She received no further management but avoided swallowing large pieces of meat.

並列關鍵字

congenital esophageal stenosis ； fibromuscular stenosis