Congenital esophagostenosis due to tracheobronchial remnant in infant: 3 cases report

Esophageal congenital stenosis due to tracheobronchial remnant is a rare deformation. Its scarcity incites us to report three observations of abnormal tracheal cartilage in the wall of the lower esophagus in infants (ages: 6; 12; 24 months). Authors present records of 3 children who underwent a radical procedure of surgery for esophageal congenital stenosis in Albert Royer's Pediatric Hospital from 2005 to 2009. Anatomopathological exam was performed to identify the cause of the stenosis and develop treatment recommendations. The study included two girls and one boy who presented vomiting, undernourishment and bad general state of health. The upper gastrointestinal radiological investigations established stenosis of distal esophagus with dilatation above. Endoscopy performed in one case showed not passable regular stenosis, located at 25 cm from dental arches. There was no abnormality of mucosal appearance above and dilation wasn't attempted for lack of pediatric dilator. Diagnosis of megaesophagus was formulated and all the infants underwent esophageal distal resection with terminal end-to-end anastomosis, HIS corner repairing and anterior partial stomach fundoplication to prevent reflux. The postoperative follow up was good and the upper gastrointestinal radiological investigations were normal after one month. The anatomopathological exam revealed tracheobronchial remnant in all cases. Authors discuss about standpoint to adopt in front of esophageal congenital stenosis due to tracheobronchial remnant. We believe that radical surgery is essential for the removal of stenosis.