Fiberoptic endoscopic diagnosis and treatment of a congenital esophageal diaphragm.

A 9-month-old infant suffering from dysphagia to solids presented with esophageal bolus obstruction. Using an adult fiberoptic esophagoscope, a congenital web was found at the junction of the middle and distal thirds of the esophagus. Previous direct rigid esophagoscopy and roentgenologic examination had not visualized the web. The web was successfully ruptured and dilated by inserting a guide wire under fiberscopic control and then inserting metal olives, followed later by blind mercury bougienage. This report illustrates the use of adult fiberoptic instruments for diagnosis and treatment in pediatric patients.