General esophageal diseases

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[size=20px]A four-year old undergoes dilation for an esophageal stricture and has a contained perforation. He is initially treated with a nasogastric tube and antibiotics. Fourteen days later a repeat esophagram shows a persistent leak and a small fluid collection adjacent to the esophagus. A decision is made to place a temporary stent. Which of the following statements is true regarding the use of esophageal stents? A the stent should be removed within one month of placement B stent migration is unlikely C tissue overgrowth will occur within a few days D only one stent may be placed at a time E surveillance esophagoscopy is unnecessary[/size]

A three-month old boy has life long symptoms of excessive drooling and regurgitation of undigested food. Both a barium esophagram and esophagoscopy show a short, tight, circular stenosis in the distal esophagus. A balloon dilation was performed and his symptoms did not improve. [size=20px]For this patient with esophageal stenosis, the next step should be A soft diet trial for six weeks. B resection of the stricture. C fundoplication. D inhaled steroids. E repeat esophagoscopy and dilation.[/size]

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[size=20px]A five year old with history of repaired esophageal atresia presents with a foreign body in the esophagus. The object is removed and an esophageal dilatation is performed for a stricture in the proximal third of the esophagus. Thirty-six hours later she presents with chest pain and fever. An esophagram is performed which demonstrates a contained leak into the mediastinum. What is the next best step in managing the esophageal perforation in this patient? A- intravenous antibiotics and nasogastric drainage B- left tube thoracostomy C- gastric transposition D- repair via a left thoracotomy E- gastrostomy and cervical esophageal diversion[/size]