A Case of Congenital Esophageal Stenosis Operated on at the Age of 23

Congenital esophageal stenosis is derived from abnormal division of tracheal and esophageal channels from foregut and is rare in the adult. We reported a 23-year-old female with congenital esophageal stenosis. The patient had a symptom of vomitting first when she took solid food for weaning in the infantile period. The symptoms of dysphagia and vomitting gradually deteriorated and the diagnosis of congenital esophageal stenosis with no other congenital malformations was made at the age of six. After this, she was managed by serial endoscopic bougienages. She was admitted to our hospital because the symptom of dysphagia worsened and endoscopic bougienages were not effective. A endoscopic examination revealed two stenotic lesions of the esophagus at 30cm and 40cm from the incisors respectively. A right thoracolaparotomic subtotal esophagectomy, intrathoracic esophagogastrostomy, cholecystectomy and pyloroplasty were performed on November 12, 1998. The pathological findings showed fibromuscular thickness in both of the stenotic lesions. We selected resection of the affected esophagus as a treatment because bougienages were not able to resolve the symptoms and there were two stenotic lesions.