Published on 25/03/2015 by admin
Filed under Pediatrics
Last modified 25/03/2015
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Chapter 312 Obstructing and Motility Disorders of the Esophagus
Seema Khan, Susan R. Orenstein
Obstructing lesions classically produce dysphagia to solids earlier and more noticeably than to liquids and can manifest when the infant liquid diet begins to incorporate solids; this is in contrast to dysphagia from dysmotility, in which swallowing of liquids is affected as early as, or earlier than, solids. In most instances of dysphagia, evaluation begins with fluoroscopy, which may include videofluoroscopic evaluation of swallowing, particularly if aspiration is a primary symptom. Secondary studies are often endoscopic if intrinsic obstruction is suspected or manometric if dysmotility is suspected; other imaging studies may be used in particular cases. Congenital lesions can require surgery, whereas webs and peptic strictures might respond adequately to endoscopic (or bougie) dilation. Peptic strictures, once dilated, should prompt consideration of fundoplication for ongoing prophylaxis.
Esophageal duplication cysts
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