Abstract
Introduction The development of stenoses after correction of an esophageal atresia or acid and
lye burn of the esophagus are well-known problems in pediatric surgery. Currently,
stenoses are treated in the majority of cases by repeated balloon dilatations. The
diameter of the balloons used is not standardized; standard curves do not exist. The
aim of this study was to evaluate the diameter of the esophagus correlated to the
body weight of the children as measured in upper gastrointestinal (GI) studies to
answer the important question to what extent a stenosis should be dilated.
Materials and Methods Within the time period from 2011 through 2016, 60 patients with upper GI studies
were selected. Evaluations were blinded to two different examiners. The diameters
were measured under maximum contrast filling between the second and third rib (cranial
point of measurement) and between the seventh and eighth rib (caudal point of measurement).
For both, the anteroposterior and lateral aspect was examined. The diameter was calculated
as the arithmetic average of both measurements within one level. The diameters were
correlated to the weight of the children.
Results All children (n = 38) within the 3rd to 97th weight percentile were analyzed. Linear correlation
and coefficients of 0.67 at the cranial point and 0.70 at the caudal point were found.
Mean diameter at the cranial point of measurement was 6.75 mm at the lowest weight
(2.6 kg) and 14 mm at 74 kg. Mean weight of these children (standard deviation [SD])
was 25.3 (18.8) kg and median age was 7 years. Within weight groups (0–10 kg; 10–20 kg;
20–35 kg; 35–50 kg; >50 kg), we calculated SD and two side tested critical 95% confidence
interval for all measurements (n = 74).
Conclusion Although the variation in measurements is considerable, this evaluation gives a reliable
hint to which extent esophageal stenoses should be dilated in relation to the body
weight. To the best of our knowledge, this is the first investigation to evaluate
the diameter of the esophagus in children in relation to the body weight.
Keywords
esophageal stenosis - diameter - body weight - balloon dilatation
