Peptic esophageal stricture in an adolescent with Barrett’s esophagus
-
Sandeep Lamoria
Abstract
Barrett’s esophagus (BE) is characterized by the replacement of distal esophageal stratified squamous epithelium by columnar epithelium. It is rare in children and the risk factors may include mental retardation, cerebral palsy, esophageal atresia, etc. Apart from corrosive ingestion, peptic stricture is the other leading cause of esophageal strictures in children. However, BE has not been well characterized in the pediatric population and in children presenting with esophageal strictures. A 16-year-old Indian boy presented with a history of gradually progressive dysphagia to solids (but not liquids) for 12 years along with heartburn and poor weight gain. Physical examination and routine blood investigations were unremarkable. Previously performed barium meal studies were suggestive of stricture in the mid and lower esophagus. Upper gastrointestinal (GI) endoscopy revealed a non-negotiable stricture with circumferential ulceration at 26 cm. The stricture was traversed using an ultrathin scope and the distal mucosa was found to be columnar. Biopsies revealed cardiac mucosa. The patient was treated with proton pump inhibitors (PPI) and four series of segmental dilatations with Savary Gilliard esophageal dilators. Peptic strictures occurring in the mid-upper esophagus should raise concerns about BE or malignancy. Here, we report a case of peptic esophageal stricture in a child without neurodevelopmental or trachea-esophageal abnormalities.
References
1. Spechler SJ, Fitzgerald RC, Prasad GA, Wang KK. History, molecular mechanisms, and endoscopic treatment of Barrett’s esophagus. Gastroenterology 2010;138:854–69.10.1053/j.gastro.2010.01.002Search in Google Scholar PubMed
2. Barrett NR. The lower oesophagus lined by columnar epithelium. Surgery 1957;41:881–94.Search in Google Scholar PubMed
3. El-Serag HB, Gilger MA, Shub MD, Richardson P, Bancroft J. The prevalence of suspected Barrett’s esophagus in children and adolescents: a multicenter endoscopic study. Gastrointest Endosc 2006;64:671–5.10.1016/j.gie.2006.03.010Search in Google Scholar PubMed
4. Cameron AJ. Epidemiology of columnar-lined esophagus and adenocarcinoma. Gastroenterol Clin N Am 1997;26:487–94.10.1016/S0889-8553(05)70308-3Search in Google Scholar
5. Gilger MA, El-Serag HB, Gold BD, Dietrich CL, Tsou V, et al. Prevalence of endoscopic findings of erosive esophagitis in children: a population-based study. J Pediatr Gastroenterol Nutr 2008;47:141–6.10.1097/MPG.0b013e31815eeabeSearch in Google Scholar PubMed
6. Nguyen DM, El-Serag HB, Shub M, Integlia M, Henderson L, et al. Barrett’s esophagus in children and adolescents without neurodevelopmental or tracheoesophageal abnormalities: a prospective study. Gastrointest Endosc 2011;73:875–80.10.1016/j.gie.2011.01.017Search in Google Scholar PubMed
7. Broor SL, Lahoti D, Bose PP, Ramesh GN, Raju GS, et al. Benign esophageal strictures in children and adolescents: etiology, clinical profile, and results of endoscopic dilation. Gastrointest Endosc 1996;43:474–7.10.1016/S0016-5107(96)70289-4Search in Google Scholar PubMed
8. Poddar U, Thapa BR. Benign esophageal strictures in infants and children: results of Savary-Gilliard bougie dilation in 107 Indian children. Gastrointest Endosc 2001;54:480–4.10.1067/mge.2001.118253Search in Google Scholar PubMed
9. Broto J, Asensio M, Vernet JMG. Results of a new technique in the treatment of severe esophageal stenosis in children: Poliflex stents. J Pediatr Gastroenterol Nutr 2003;37:203–6.10.1097/00005176-200308000-00024Search in Google Scholar PubMed
10. Spechler JS, Souza RF. Barretts Esophagus. In: Sleisenger M, Feldman M, Friedman L, Brandt L, Fordtran J, editors. Sleisenger and Fordtran’s gastrointestinal and liver disease. 10th ed. Philadelphia: Saunders Elsevier, 2016:755–63.Search in Google Scholar
11. Mathew P, Joshi AS, Shukla A, Bhatia SJ. Risk factors for Barrett’s esophagus in Indian patients with gastroesophageal reflux disease. J Gastroenterol Hepatol 2011;26:1151–6.10.1111/j.1440-1746.2011.06714.xSearch in Google Scholar PubMed
©2017 Walter de Gruyter GmbH, Berlin/Boston
Articles in the same Issue
- Physical activity: start at a younger age
- The winner takes it all? Characteristics of adolescent at-risk/problem gamblers in Switzerland
- Laboratory screening in overweight/obese adolescents: do the results change the management?
- Sexual health knowledge in a vulnerable population: a survey of adolescents in the bateyes of La Romana, Dominican Republic
- Socio-demographic association of non communicable diseases’ risk factors in a representative population of school children: a cross-sectional study in Sousse (Tunisia)
- Consumption of sugar-sweetened beverages and energy drinks and adherence to physical activity and screen time recommendations among adolescents
- Metformin effectiveness and safety in the management of overweight/obese nondiabetic children and adolescents: metabolic benefits of the continuous exposure to metformin at 12 and 24 months
- Implications for visually stimulating advertisements on NYC subway platforms
- A study on the relationship of sociocultural characteristics, menstrual hygiene practices and gynaecological problems among adolescent girls in Eastern India
- Cultural considerations for the adaptation of an Internet-based intervention for depression prevention in Mainland China
- Follow-up and outcomes of pregnancies in French Guiana: the part of teenage pregnancies
- Prevalence and risk factors for traumatic dental injuries in adolescent children attending special needs schools in India: a comparative study
- Prevalence of lesbian, gay, bisexual, and transgender among Japanese university students: a single institution survey
- Personality differences in treatment-seeking and non-treatment-seeking individuals with self-reported anorexia
- Peptic esophageal stricture in an adolescent with Barrett’s esophagus
- Is emotional eating a problem of concern among adolescents in poor countries? An example from Sudan
Articles in the same Issue
- Physical activity: start at a younger age
- The winner takes it all? Characteristics of adolescent at-risk/problem gamblers in Switzerland
- Laboratory screening in overweight/obese adolescents: do the results change the management?
- Sexual health knowledge in a vulnerable population: a survey of adolescents in the bateyes of La Romana, Dominican Republic
- Socio-demographic association of non communicable diseases’ risk factors in a representative population of school children: a cross-sectional study in Sousse (Tunisia)
- Consumption of sugar-sweetened beverages and energy drinks and adherence to physical activity and screen time recommendations among adolescents
- Metformin effectiveness and safety in the management of overweight/obese nondiabetic children and adolescents: metabolic benefits of the continuous exposure to metformin at 12 and 24 months
- Implications for visually stimulating advertisements on NYC subway platforms
- A study on the relationship of sociocultural characteristics, menstrual hygiene practices and gynaecological problems among adolescent girls in Eastern India
- Cultural considerations for the adaptation of an Internet-based intervention for depression prevention in Mainland China
- Follow-up and outcomes of pregnancies in French Guiana: the part of teenage pregnancies
- Prevalence and risk factors for traumatic dental injuries in adolescent children attending special needs schools in India: a comparative study
- Prevalence of lesbian, gay, bisexual, and transgender among Japanese university students: a single institution survey
- Personality differences in treatment-seeking and non-treatment-seeking individuals with self-reported anorexia
- Peptic esophageal stricture in an adolescent with Barrett’s esophagus
- Is emotional eating a problem of concern among adolescents in poor countries? An example from Sudan
