BENIGN ESOPHAGEAL STRICTURES IN CHILDREN AND ADOLESCENTS - ETIOLOGY, CLINICAL PROFILE, AND RESULTS OF ENDOSCOPIC DILATION

Background: The problem of dysphagia in children and adolescents diffe rs from that in adults, and therefore requires special consideration. Methods: Forty-one consecutive children and adolescents 16 years of ag e or younger (mean, 7.2 years), with benign esophageal strictures were evaluated in a prospective manner over a 7-year period. The most freq uent causes of esophageal strictures were caustic ingestion and compli cations of endoscopic sclerotherapy of esophageal varices. Dilation wa s done on a weekly basis using bougies and was considered adequate if the esophageal lumen could be dilated to 15 mm diameter (11 mm in chil dren less than 5 years old) with complete relief of dysphagia. Results : Of the 30 patients who could be adequately followed after initial di lation, 16 had corrosive strictures and 14 had strictures due to other causes. Patients with corrosive strictures required a significantly h igher number of sessions for adequate initial dilation (7.8 +/- 2.5 se ssions vs 1.86 +/- 0.48 sessions; p < 0.01). Patients with corrosive s trictures had a higher number of mean symptomatic recurrences per pati ent month as compared to the noncorrosive stricture group (0.15 +/- 0. 01 vs 0.087 +/- 0.03, p < 0.01). Six esophageal perforations occurred during a total of 327 dilation sessions (1.8%); there was one fatality . Conclusions: From our experience, we conclude that benign esophageal strictures in young patients can be treated effectively and with acce ptable safety by means of endoscopic dilation.