Dysphagia, Regurgitation 1 (Differential Diagnosis)

This 1-year-old girl has a chronic dysphagia and regurgitation which became obvious when the patient started to eat from the table. The esophagography shows smooth outlines of the wall of the proximal and distal esophagus which is divided by a localized narrowing. It is a congenital intrinsic esophageal stenosis due to a web with a small central hole. Congenital and acquired stenoses of the esophagus are differential diagnoses of hypertrophic pyloric stenosis due to the dysphagia and the regurgitation which are interpreted as vomiting. Acquired esophageal stenoses occur more frequently than congenital forms; they occur with or after gastroesophageal reflux, esophageal foreign bodies, and caustic esophageal lesions. Except for peptic esophageal stenosis - $$haem_01??££see alternate picture§§ - they play only rarely a role in the differential diagnosis of hypertrophic pyloric stenosis because of the age at the time of occurrence (mostly toddlers are involved).