Abstract Ref Number = APCP243
ENDOSCOPIC BALLOON DILATATION FOR ANASTOMOTIC STENOSIS OF ESOPHAGEAL ATRESIA ON PEDIATRIC PATIENT: A CASE REPORT
Budi Purnomo, Eva Jeumpa Soelaeman, Karina Kalani Firdaus, Ariani Dewi Widodo
Gastrohepatology Working Group, Department of Pediatrics, Harapan Kita Women and Children Hospital, Jakarta
General Practitioner, Harapan Kita Women and Children Hospital, Jakarta
Background Endoscopic Balloon Dilatation (EBD) is one of the most frequent therapeutic endoscopyprocedure at Harapan Kita Women and Children Hospital,with a tendency to increase every year. EBD is indicated in conditions such as narrowing of the esophageal lumen,anastomotic stenosis (AS) after esophageal atresia repair in this case. AS is defined as narrowing that results in dysphagia, regurgitation, oxygen desaturation during feeding and aspiration after esophageal atresia repair, and complicates one-third of the patients.
Case Presentation A 2-year-old male infant presented with vomiting and regurgitation since change of diet at the age of 7 months. The infant was born with esophageal atresia and underwent anastomotic esophageal surgery due to esophageal atresia.After weaning, at the age of 6 months, recurrent regurgitation followed after feeding.Esophagogram and endoscopy confirmed AS diagnosis. At 8 months, first balloon dilatation was done with pressure of 4, 6, 8 atmat2-minute interval. Six months later, similar complaints led to a second endoscopy that confirmed re-stenosis at the same location. Dilatation was performed with balloon size 8, 9, and 10, on pressures of 4,6,8atm with 2-minute interval. Repeat dilatation was performed 1 month laterwith balloon size 10,11, and 12, on pressures of 2,4,6 atm with 2 minute interval, and has not recurrent since then.
Learning Point Patients with history of esophageal atresia repair and complaint of regurgitation or vomiting, especially after 6 months of age, should be evaluated for AS. No consensus has been established for the ideal interval between dilatation sessions but most studies prefer between 2 weeks to monthly sessions.
Keywords: balloon dilatation anastomotic stenosis endoscopy esophageal atresia vomiting