Savary Dilation is Safe and Effective Treatment for Esophageal Narrowing Related to Pediatric Eosinophilic Esophagitis.

Objectives: Data on management of esophageal narrowing related toeosinophilic esophagitis (EoE) in children is scanty. We aim to assess the safety and effectiveness of esophageal dilation in pediatric EoE from the largest case series to date. Methods: Children diagnosed withEoE during 2004 - 2015 were reviewed for the presence of esophageal narrowing. Esophageal narrowing was categorized as short segment narrow caliber, long segment narrow caliber, and single short stricture. The characteristics of the narrowed esophagus, therapeutic approach, clinical outcome and complications were reviewed. Results: Of the 50EoE cases diagnosed during the study period, 11 cases (9 males; median age 9 years, range 4-12) were identified with esophageal narrowing (22%). Six had short segment narrow caliber esophagus and 5 had long segment narrow caliber esophagus (median length of the narrowing was 4 cm, range 3-20 cm). Three cases with narrow caliber esophagus also had esophageal stricture 2-3 cm below the upper esophageal sphincter. Nineteen dilation sessions were performed in 10 cases using Savary dilator. Esophageal size improved from median 7 mm to median 13.4 mm. Good response was obtained in all cases. Following the dilation procedure, longitudinal esophageal mucosal tear occurred in all cases without esophageal perforation or chest pain. Conclusions: Esophageal dilation using Savary dilator is safe and highly effective in the management of esophageal narrowing related toEoE in children. Dilation alone does not improve the inflammatory process, and hence a combination with dietary or medical intervention is required. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives 4.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://ift.tt/OBJ4xP (C) 2016 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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