# Esophageal Stenosis — GCMD Library living collection

Everything in the library about esophageal stenosis — built automatically from dossiers that name it.

Updated: n/a · 3 episodes · 62 cited statements

## Episodes
### Surgical Management
- [Tricks - Indwelling Balloon Catheter For Refractory Esophageal Stenosis](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640) — video · 23:57 · [machine version](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640.md)

### Evidence & Research
- [Revisión bibliográfica sobre atresia esofágica: manejo quirúrgico y complicaciones](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950) — podcast · 16:57 · [machine version](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950.md)

### In-Depth Reviews
- [Management of Esophageal Stenosis and Strictures in Children | Congenital & Acquired w/ Dr. Walther](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905) — video · 6:10 · [machine version](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=0) Indwelling balloon catheter technique for refractory esophageal stenosis (Ep 1)
- [7:46](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=466) Faculty discussion of technique mechanics and nasal complications (Ep 1)
- [10:43](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=643) Duration of therapy and management of reflux strictures (Ep 1)
- [13:35](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=815) Inflation protocol, removal criteria, and comparison with mitomycin (Ep 1)
- [19:32](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=1172) Expandable metal stents: adult experience and pediatric complications (Ep 1)
- [0:00](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=0) Introduction and vagus nerve preservation (Ep 2)
- [3:20](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=200) Fistula management and postoperative stenosis (Ep 2)
- [8:12](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=492) Role of postoperative drainage (Ep 2)
- [11:13](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=673) Acid suppression therapy (Ep 2)
- [14:51](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=891) Conclusions and closing (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=0) Introduction and Congenital Esophageal Stenosis Types (Ep 3)
- [1:10](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=70) Acquired Stenosis and Diagnostic Workup (Ep 3)
- [1:42](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=102) Dilation Techniques and Surgical Resection (Ep 3)
- [2:27](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=147) Esophageal Replacement Options (Ep 3)
- [4:04](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=244) Medical Management and Endoscopic Options (Ep 3)
- [5:16](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=316) Summary and Key Takeaways (Ep 3)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- There are both congenital and acquired esophageal stenosis — Ashley Walther (clinical) [Ep 3 · 0:22](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=22)
- Fibromuscular hypertrophy is the most common type of congenital esophageal stenosis — Ashley Walther (clinical) [Ep 3 · 0:34](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=34)
- Congenital esophageal stenosis can also present as tracheal bronchial remnants or mucosal webs — Ashley Walther (clinical) [Ep 3 · 0:36](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=36)
- Congenital esophageal stenosis is associated with EATEF, esophageal duplications, congenital heart disease, anorectal malformations, and VACTERL — Ashley Walther (clinical) [Ep 3 · 0:45](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=45)
- Fibromuscular hypertrophy occurs in the middle to lower third of the esophagus — Ashley Walther (clinical) [Ep 3 · 0:57](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=57)
- Tracheal bronchial remnants occur in the lower third of the esophagus — Ashley Walther (clinical) [Ep 3 · 0:57](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=57)
- Acquired esophageal stenosis includes peptic stricture from GERD, caustic ingestion, or iatrogenic stricture from perforation — Ashley Walther (clinical) [Ep 3 · 1:10](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=70)
- Workup for esophageal stenosis starts with an esophagram — Ashley Walther (guideline) [Ep 3 · 1:23](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=83)
- The first treatment attempted is usually dilation — Ashley Walther (guideline) [Ep 3 · 1:42](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=102)
- There are two types of dilators: bougie dilation and balloon dilators — Ashley Walther (clinical) [Ep 3 · 1:45](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=105)
- Balloon dilation provides more controlled dilation with equal pressure and can be done under fluoroscopic guidance — Ashley Walther (clinical) [Ep 3 · 1:55](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=115)
- Resection of congenital esophageal stenosis can be performed thoracoscopically — Ashley Walther (clinical) [Ep 3 · 2:17](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=137)
- Three main esophageal replacement techniques are gastric pull-up, jejunal interposition, and colonic interposition — Ashley Walther (clinical) [Ep 3 · 2:28](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=148)
- Gastric pull-ups carry long-term risks of dilation and redundancy, creating a space-occupying lesion in the chest over time — Ashley Walther (clinical) [Ep 3 · 2:41](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=161)
- Jejunal interposition is a very complex surgery that should be performed at a major center with all important personnel in place — Ashley Walther (opinion) [Ep 3 · 3:03](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=183)
- Colonic interposition uses pieces of transverse or descending colon, performed either isoperistaltic or antiperistaltic depending on mesenteric blood supply — Ashley Walther (clinical) [Ep 3 · 3:30](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=210)
- The colon does not peristalse like the esophagus or bowel, so with antiperistaltic placement gravity pulls food down and the colon becomes dilated over time — Ashley Walther (clinical) [Ep 3 · 3:48](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=228)
- Colonic interpositions sometimes become stretched out and redundant, requiring revision — Ashley Walther (clinical) [Ep 3 · 3:59](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=239)
- For peptic strictures, treatment should address the underlying reflux rather than the stricture itself — Ashley Walther (guideline) [Ep 3 · 4:12](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=252)
- Endoscopic options for strictures include needle knife stricturoplasty, which uses a thin device to score the strictured area in multiple places — Ashley Walther (clinical) [Ep 3 · 4:30](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=270)
- EOE strictures are related to a disease process and are different from other stricture types — Ashley Walther (clinical) [Ep 3 · 4:54](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=294)
- Dupixent, a monoclonal antibody given via weekly injection, is a medication for EOE — Ashley Walther (clinical) [Ep 3 · 5:08](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=308)
- If EOE persists despite medical treatment, dilation is performed — Ashley Walther (guideline) [Ep 3 · 5:14](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=314)
- Esophageal stenosis after atresia repair or reflux esophagitis can be managed with balloon dilatation, but persistent stenosis has increasing recurrence rates requiring repeated dilatation. — David (clinical) [Ep 1 · 0:03](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=3)
- The technique was first tried approximately 10 years ago, involving transnasal insertion of dilatation balloons under direct esophagoscopic vision, placement at the stenosis site, and intermittent inflation three times daily for 10 seconds followed by desufflation. — David (clinical) [Ep 1 · 1:30](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=90)
- The rationale is that the esophagus will heal at least to the diameter of the balloon (e.g., 10 millimeters for a 10mm balloon), which is usually sufficient. — David (clinical) [Ep 1 · 3:00](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=180)
- Compared to stents, balloons have very little dislodgement because the balloon is fixed to the catheter exiting through the nose. — David (clinical) [Ep 1 · 3:30](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=210)
- Children can drink or eat solid foods alongside the indwelling balloon. — David (clinical) [Ep 1 · 4:00](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=240)
- Olympus endotherapy balloons were initially used, but when unavailable, Boston Scientific Ultrasin vascular stent balloons were substituted successfully. — David (clinical) [Ep 1 · 4:40](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=280)
- Balloons are available in different sizes and lengths, allowing selection based on patient age and desired diameter; for extensive burns, two balloons can be used simultaneously (e.g., 8cm and 4cm balloons). — David (clinical) [Ep 1 · 5:20](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=320)
- The patient series included 5 long-gap atresia cases with stenosis, 2 type C atresia cases, 7 caustic burns, 3 stenoses of unknown cause, and 2 persistent reflux cases despite anti-reflux surgery. — David (epidemiological) [Ep 1 · 6:40](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=400)
- Caustic burn and unknown-cause stenosis patients required prolonged dilatation periods, but the technique reduced the number of required endoscopies to approximately once every 4 weeks. — David (clinical) [Ep 1 · 7:30](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=450)
- Complications included restenosis in 6 children after balloon removal at 4-6 weeks, managed by reinsertion for another 4-6 weeks; occasional dislodgement when children manipulated the catheter; balloon leakage requiring replacement; and one case of sputum retention leading to removal. — David (clinical) [Ep 1 · 8:10](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=490)
- There was no mortality and no patient required surgical intervention (reanastomosis, esophagoscopy, or esophageal replacement). — David (clinical) [Ep 1 · 9:20](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=560)
- In a 16-year-old with a 10cm lye burn stenosis, two balloons (8cm lower, 4cm upper) were used simultaneously, achieving complete healing in approximately 3 months with the patient able to eat solids within 2-3 weeks. — David (clinical) [Ep 1 · 10:20](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=620)
- The technique can be taught to parents for home use, is safe, and obviates the need for reanastomosis, esophagoscopy, or esophageal replacement. — David (opinion) [Ep 1 · 11:40](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=700)
- The principle of frequent dilatation promoting healing in the open position is analogous to historical practice of passing Maloney bougies multiple times daily at the bedside. — Jack (clinical) [Ep 1 · 7:49](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=469)
- The balloon technique differs from bougie dilatation in that after initial dilatation under anesthesia, subsequent inflations only maintain patency and are not painful. — David (clinical) [Ep 1 · 9:03](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=543)
- A small child who swallowed a battery lodged in the upper sphincter was successfully managed with a 4cm 10mm balloon using gradual inflation (5cc warning inflation followed by full inflation) to allow the child to swallow, with no complications. — David (clinical) [Ep 1 · 9:40](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=580)
- The catheters are stiffer than standard nasogastric or silastic tubes; the tip must be bent for nasal introduction, or a guide wire can be used to facilitate replacement without anesthesia. — David (clinical) [Ep 1 · 10:40](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=640)
- In small children, the catheter may need to be forcefully bent into a hook shape at the nasal exit point and fixed with Duoderm and plaster; nasal wing distortion can be prevented by tying the catheter to the opposite side with umbilical tie material. — David (clinical) [Ep 1 · 11:20](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=680)
- Initial dilatation typically involves 1-3 sessions before recognizing persistence; at that point, the balloon is left indwelling for 2 weeks initially (if severe inflammation) or 4-week stretches for burns, with endoscopic reassessment and possible replacement. — David (clinical) [Ep 1 · 10:55](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=655)
- The dual-lumen catheters allow tube feeding through the catheter while the balloon is indwelling. — David (clinical) [Ep 1 · 11:43](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=703)
- In the two reflux stricture cases, both experienced restenosis; one retarded child with mid-esophageal stenosis and pH study showing no reflux (pH=1) after anti-reflux surgery was ultimately treated with swallowed transanal steroid gels, leading to resolution and remaining symptom-free approximately 2 years later. — David (clinical) [Ep 1 · 12:02](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=722)
- Caustic burn cases required indwelling periods of 3-6 months to ensure complete healing before catheter removal. — David (clinical) [Ep 1 · 13:10](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=790)
- The inflation protocol uses a 20cc syringe with air only (no fluids to prevent balloon adhesion); initial 5cc inflation alerts the child to swallow, followed by full inflation to 15-20cc, then immediate complete desufflation with vacuum, performed three times daily. — David (clinical) [Ep 1 · 14:32](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=872)
- First endoscopic reassessment occurs at 2 weeks; if progress is satisfactory, intervals can be extended to 4 weeks until complete healing is observed, at which point the catheter is removed and the child monitored for symptoms without routine contrast studies or endoscopy unless complaints arise. — David (clinical) [Ep 1 · 15:30](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=930)
- Two patients in the series experienced recurrent stricture after initial successful treatment and catheter removal, requiring an additional 4-6 week period of balloon dilatation. — David (clinical) [Ep 1 · 16:26](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=986)
- Balloon position is marked by two metal spots on the catheter visible on radiography; position can be confirmed with contrast swallow or, under anesthesia, by endoscopic visualization with placement approximately 1cm above the stenosis for a 4cm balloon, followed by fixation at the nose before deflation. — David (clinical) [Ep 1 · 17:08](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=1028)
- Dislodged balloons can be replaced under fluoroscopy without anesthesia. — David (clinical) [Ep 1 · 18:16](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=1096)
- Topical mitomycin application for recurrent esophageal strictures usually requires a few treatments and has maintained patency in patients with dozens of prior dilatations. (clinical) [Ep 1 · 18:23](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=1103)
- Mitomycin is applied topically, not injected, for esophageal strictures. (clinical) [Ep 1 · 19:06](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=1146)
- Fully covered metal stents do not require transnasal placement and may be more comfortable than balloons. — JP (opinion) [Ep 1 · 21:00](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=1260)
- Injection of steroids into the esophageal wall has been useful for recalcitrant or recurrent strictures. — JP (clinical) [Ep 1 · 21:20](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=1280)
- Metal expandable stents have caused catastrophic complications in pediatrics, including erosion through the esophagus into an aberrant innominate artery causing fatal exsanguination; multiple pediatric surgeons have had similar unreported disasters. (clinical) [Ep 1 · 21:04](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=1264)
- In small children with atresia, metal stents must be very carefully size-matched to the esophagus to prevent erosion; nitinol is unforgiving and will erode if not the right size. (clinical) [Ep 1 · 21:51](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=1311)
- Biodegradable stents are available in Europe and the UK with limited data but represent the future; they dissolve after 4-6 weeks. (clinical) [Ep 1 · 22:13](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=1333)
- Newer fully covered metal stents can be removed by pulling a central string to collapse them; nitinol stents should be pre-treated with cold water through the lumen to cause shrinkage before string-pulling and removal. — JP (clinical) [Ep 1 · 22:23](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=1343)
- Patients with indwelling balloon catheters can tolerate semi-solid food. (clinical) [Ep 1 · 22:49](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=1369)
- Postoperative esophageal stenosis occurs in general with early feeding, typically within days of the procedure (clinical) [Ep 2 · 5:31](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=331)
- The limitation of the drainage paper is that it does not clearly explain the differences in the repairs (opinion) [Ep 2 · 9:01](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=541)
- There is much controversy regarding the use of acid suppression therapy because there is no control of how much is used and no clear indication for its use (opinion) [Ep 2 · 13:55](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=835)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- CT is reserved for cases where extrinsic compression or vascular rings are suspected — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 1:37](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=97)
- Bougie dilators are tapered and pressure is applied until resistance is felt — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 1:49](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=109)
- Short congenital strictures that fail dilation are best treated with resection — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 2:12](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=132)
- Long strictures often require esophageal replacement — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 2:24](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=144)
- Jejunal interposition is the most similar to the esophagus and is less likely to dilate with lower risk of reflux — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 2:57](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=177)
- Jejunal interposition carries the highest risk of complication among the three replacement options, including high risk of ischemia and conduit loss — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 3:12](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=192)
- Most jejunal interposition patients require G-tube feeds because it is hard to take in a normal volume of food with jejunum as the conduit — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 3:20](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=200)
- Complications of colonic interposition include leak or stricture at the proximal anastomosis — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 3:42](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=222)
- Management of peptic strictures usually involves high-dose proton pump inhibitors — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 4:16](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=256)
- If peptic stricture persists after medical management, Nissen fundoplication can be considered — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 4:20](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=260)
- Kenalog is injected during endoscopic stricturoplasty to prevent scarring and dilation — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 4:42](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=282)
- In eosinophilic esophagitis, inflammation leads to strictures — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 4:52](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=292)
- Diagnosis of EOE requires upper endoscopy and biopsy to show the presence of eosinophils — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 4:59](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=299)
- Treatment of EOE starts with food elimination and topical steroids — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 5:05](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=305)
- Esophageal replacement options all carry significant risk and should be performed at experienced centers — Jill Knepprath summarizes what Dr. Ashley Walther said [Ep 3 · 5:46](https://library.globalcastmd.com/watch/management-of-esophageal-stenosis-and-strictures-in-children-congenital-acquired-16905?t=346)
- A recent article in the Journal of Gastrointestinal Surgery reviews fully covered metal expandable stents for both leaks and strictures, showing outstanding results with average indwelling periods of 4-5 weeks, though migration can occur and sometimes requires one stent inside another. — JP summarizing the discussion [Ep 1 · 19:58](https://library.globalcastmd.com/watch/tricks-indwelling-balloon-catheter-for-refractory-esophageal-stenosis-640?t=1198)
- Comparison of patients with vagus nerve preservation versus non-preservation shows no relationship between preservation status and esophageal stenosis rates — The host summarizing the discussion [Ep 2 · 2:31](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=151)
- Vagus nerve preservation status shows no relationship with anastomotic leak rates — The host summarizing the discussion [Ep 2 · 2:31](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=151)
- Vagus nerve preservation status shows no relationship with pneumonitis rates in patients — The host summarizing the discussion [Ep 2 · 2:31](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=151)
- The recommendation is to preserve the vagus nerve during esophageal atresia repair — The host summarizing the discussion [Ep 2 · 2:55](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=175)
- A systematic review evaluated the benefit of drainage placement in neonates with esophageal atresia repair, analyzing approximately eight studies — The host summarizing the discussion [Ep 2 · 8:12](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=492)
- There was no difference in postoperative complications between patients who had drainage and those who did not — The host summarizing the discussion [Ep 2 · 8:35](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=515)
- There was no difference in pneumonia rates between patients with and without drainage — The host summarizing the discussion [Ep 2 · 8:35](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=515)
- Patients with drainage had a higher mortality rate compared to those without drainage — The host summarizing the discussion [Ep 2 · 8:35](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=515)
- Drainage does not show a difference in the development of leak — The host summarizing the discussion [Ep 2 · 10:17](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=617)
- Drainage may have utility in the diagnosis of leak — The host summarizing the discussion [Ep 2 · 10:17](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=617)
- Drainage placement may produce more complications overall — The host summarizing the discussion [Ep 2 · 10:45](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=645)
- The association between acid suppression and stenosis is another problem, and the utility of acid suppression was not found in this work — The host summarizing the discussion [Ep 2 · 14:16](https://library.globalcastmd.com/watch/revisi-n-bibliogr-fica-sobre-atresia-esof-gica-manejo-quir-rgico-y-complicacione-5950?t=856)

## Changelog
- Nov 13: 3 items added automatically

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