Esophageal duplication in childhood. Report of seven cases.

Esophageal duplications represent 10 to 20% of esophageal malformations and 15 to 20% of digestive duplications, Methods. - The authors report a series of seven cases observed between 1985 and 1999. Results. - The sex ratio was 2.5. The diagnosis was made before the age of six months in five cases. The clinical presentation included respiratory si gns in six cases and digestive signs in five cases. The diagnosis was made on the association of a mediastinal mass behind vertebral malformation in f ive cases. The duplication was cystic in five cases and tubular in two. A p erforation in the pleura occurred in one case of tubular duplication. The i ntervention consisted of total excision of the duplication in four cases an d subtotal resection in two cases. For the seventh patient, who presented a perforation of the duplication in the pleura, the operation comprised a th oracic drainage associated to feeding gastrostomy. The histologic examinati on of the six operative specimens confirmed the diagnosis of esophageal dup lication. Six patients survived and have favorable evolution with an averag e follow-up of four years. Discussion. - Esophageal duplications represent 15 to 20% of digestive dupl ications. Their clinical presentations are variable. Their diagnosis is oft en made before the age of two years, when a posterior mediastinal mass is a ssociated with vertebral malformations. Apart from the tubular form, which is rare, diagnosis is confirmed by the histologic study of the operative sp ecimen. Conclusion. - Esophageal duplications are rare and often pose a problem of positive diagnosis. Their treatment is surgical and should be undertaken be fore the appearance of complications. (C) 2001 Editions scientifiques et me dicales Elsevier SAS.