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Revista Cubana de Pediatría
On-line version ISSN 1561-3119
Abstract
FRAGOSO ARBELO, Trini et al. Estenosis esofágicas benignas: tratamiento con las bujías de Savary-Gilliard. Rev Cubana Pediatr [online]. 2001, vol.73, n.3, pp. 173-180. ISSN 1561-3119.
60 patients under 15 with esophageal stenosis, 40 of them due to caustic ingestion and 20 by other causes, susceptible to the treatment of endoscopic dilatation, were studied. It was performed with general anesthesia, using an Olympus GIF-XP10 endoscope and under fluoroscopic screen with Savary-Gilliard bougies, pediatric model. In the esophageal stenoses secondary to caustic ingestion, endoscopic betamethasone injection therapy was associated with the treatment. 66.6 % of the series were caused by caustic ingestion, whereas 20 % were due to postsurgical causes. 70 % of the postcaustic ingestion group were classsified as severe according to X-rays. The most frequent localization of stenosis was the upper third of the esophagus with predominance of the tubular variety among those caused by caustic ingestion and of the annulate variety in the other causes. In the postcaustic ingestion group, 919 dilatations were carried out in 288 sessions, whereas 223 were performed in 67 sessions in those originated by other causes. 8 perforations, 1 sepsis and 3 pseudodiverticula were reported as complications in the group that ingested caustics. There was no mortality. Those who ingested caustics needed a higher average number of sessions and dilatations than the other group. 47.5 % of them were cured in this group, whereas 95 % healed in the other group. It was proved that Savary-Gilliard method of esophageal dilatations is safe, efficient and has a minimum of complications.
Keywords : ESOPHAGEAL STENOSIS [therapy]; ESOPHAGEAL STENOSIS [chemically induced]; BURNS, CHEMICAL [therapy]; DILATATION [instrumentation]; ENDOSCOPY, DIGESTIVE SYSTEM [instrumentation]; ESOPHAGOSCOPIES; BETAMETHASONE [therapeutic use]; CHILD.