Tubular Duplication of the Esophagus in a Newborn, Treated by Thoracoscopy

Oesophageal injury mimicking a tubular congenital oesophageal duplication-a diagnostic dilemma: a case report

Intramural oesophageal dissection (IED) is an uncommon condition in newborns marked by the separation of the mucosal and submucosal layers of the oesophageal wall, both transversely and longitudinally, which may or may not involve perforation. A neonate presented at 26 h of life with poor respiratory effort and lethargy. She was intubated and was put on mechanical ventilation. Radiograph of the neonate suggested malpositioned endotracheal tube. The fluoroscopic dye-study indicated gastroesophageal oesophageal reflux disease and nothing significant. On limited CT contrast study of thorax, a tubular structure was seen running just parallel to the oesophagus extending from the T2 to the T9 levels. Possibilities of a oesophageal duplication/IED were considered. The neonate underwent an endoscopy and gastrostomy on day of life (DOL) 9. On follow up at 3 months a repeat limited CT study was done with instillation of water-soluble contrast. The previously seen tubular structure running parallel to the oesophagus was no longer seen. This finding suggested a healed IED. This case report emphasizes the significance of multimodality imaging in the diagnosis of this condition.

An Uncommon Cause of Recurrent Dysphagia and Chest Pain in an Adolescent Boy

An 11-year-old boy was brought to the emergency department with a week-long history of widespread pain in his upper abdomen that worsened with deep breathing and eating, sialorrhea, food impaction sensation, and a recent fever. Ten months prior, he had similar symptoms and was diagnosed with a pharyngeal phlegmon. He was treated with antibiotics and dexamethasone. In the current episode, he presented with mild elevation of inflammatory markers, a slight deviation of the trachea on chest X-ray, and a tubular esophageal duplication was identified on a thoracic CT, with its opening observed during the endoscopic study. The patient was admitted for further treatment with fluids, analgesia, and antibiotics, and showed improvement over the next seven days with no significant incidents. Esophageal duplications are a rare congenital anomaly and their exact cause is unknown. Typically found in the posterior mediastinum and lower esophagus, they can cause symptoms such as pain, dysphagia, regurgitation, and malnutrition. Surgical or endoscopic resection can be a treatment option for these malformations.

Reconstruction of Adult Tubular Esophageal Duplication with Supraclavicular Artery Island Flap: A Rare Case Presentation

Adult esophageal duplication (ED) is a rare congenital anomaly that is rarely encountered in clinical practice. There have been only a few reported cases of adult tubular esophageal duplication. A patient presented with symptoms of odynophagia and dysphagia. Upon examination, gastroscopy and X-ray contrast imaging revealed the formation of a fistula in the upper esophagus that connected to a sinus tract running along the esophagus. After managing the initial infection, an open surgery was performed. The esophageal tubular duplication was removed and the defect was reconstructed using a supraclavicular artery island (SAI) flap. The post-operative recovery was uneventful and the patient's odynophagia and dysphagia were relieved. In conclusion, ED can be effectively diagnosed through esophagogram and gastroscopy. Surgical excision is currently the preferred treatment option, and the use of the SAI flap technique shows great promise in reconstructing the esophageal defect after surgery.

Endoscopic septum division of tubular esophageal duplication in two children and systematic review

Tubular esophageal duplication is a rare congenital malformation The surgical treatment of this lesion can be challenging. We aimed to present our experience in two cases with tubular esophageal duplication. Both cases were endoscopically treated by a dual knife. The first patient underwent a single, while the second patient required three sessions of endoscopic septum division using an electrosurgical knife. Both showed satisfactory clinical, radiological and endoscopic response to treatment. Moreover, a systematic literature review has been performed. To identify all available studies, a detailed search on tubular esophageal duplication was performed according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Tubular esophageal duplication was reported in 16 pediatric cases in 14 studies in the literature. Surgery was applied to 10 of these cases and endoscopic treatment was applied to two of them. In the follow-up, nine patients who underwent surgical treatment and two patients who underwent endoscopic treatment were uneventful. Tubular esophageal duplications can be successfully treated endoscopically. Endoscopic septum division is a minimally invasive procedure that allows full anatomical recovery and satisfactory therapeutic response.