Esophagoscopy
Introduction
Esophagoscopy is the visual examination of the esophagus. Both flexible and rigid instruments are available for this procedure.
Indications
The presence or suspected presence of esophageal pathology (burn, stricture, fistula) or foreign body is the indication for esophagoscopy.
Preoperative Evaluation
Radiographic evaluation with plain film and/or contrast study is usually performed prior to esophagoscopy.
35-1 Flexible Esophagoscopy
Introduction
Flexible esophagoscopy has the advantage of being relatively atraumatic, but is less suitable than rigid esophagoscopy for foreign body removal or dilatation of other instrumentation of the esophagus. However, excellent examination of the mucosa can be obtained using this technique.
Operative Technique
1. The child is supine and under adequate endotracheal anesthesia.
2. After protecting the teeth with a mouthguard, the esophagoscope can be inserted into the mouth and advanced to the area of the esophageal inlet.
3. The flexible instrument is advanced through the esophagus (Fig. 35.1a) as the lumen is continually in view until the rugal folds are identified (Fig. 35.1b).
4. The esophagus is examined again as the instrument is withdrawn.
Complications
Esophageal perforation
