Endoscopic radial incision to treat a congenital esophageal stenosis in a ten-year-old child

A 10-year-old boy was admitted to our hospital because of frequent vomiting and impaired growth. Esophagogastroduodenoscopy showed there was a benign annular stenosis (diameter 0.6 cm) of the middle esophagus. Then, using an ultrafine painless gastroscope, we observed that the narrowed segment was approximately 2.0 cm in length. The stenosis of the esophagus was diagnosed as congenital esophageal stenosis (CES). Then，the patient was referred for endoscopic radial incision (ERI) under general anesthesia. We used an insulated-tip knife to perform ERI. A radial incision was made to cut the muscle layer along the line that connects the esophageal lumen on the oral side and the lumen on the anal side in the 3 and 6 o'clock directions . The diameter of the esophagus was approximately 1.0 cm post-operation. The gastroscopy was able to pass through smoothly. The operation time was approximately 30 minutes. The child's oral liquid diet started on postoperative day 1 and was discontinued on postoperative day 4. Vomiting was significantly relieved for the patient. No intraoperative and postoperative complications were detected. An endoscopy performed 3 months post-operation showed smooth esophageal mucosa, and the diameter of the esophageal lumen increased to approximately 1.0 cm without recurrent stenosis .