Management of tubular oesophageal duplication- A novel approach

Background and aim: Oesophageal duplication is a rare congenital malformation which occurs due to embryogenesis errors. It accounts for 15% of all digestive tract duplications, most common be-ing ileal duplications. Here we report a case of tubular Oesophageal duplication and a novel sur-gical approach for its management.6 year male child, 11 kgs, presented with progressive dysphagia to solids > liquids since birth. He had stunted growth, height and weight were less than 50th percentile. On investiga-tions, Barium swallow and CECT neck with thorax was done to diagnose the pathology and define anatomy. It reported that the child had a congenital partial duplication of the proximal and mid esophagus with midline fold/membrane approximately 6 cm from C5 to D7 level with a dilated lower esophagus and a large hiatal hernia with focal stricture in the right lumen of proximal end. Surgical management was done by excision of oesophageal septum by endoscopic staplers via a gastrotomy under endoscopic guidance per orally and via gastrotomy.Results: Gradually diet started and well tolerated, to be kept on endoscopic surveillance.Conclusions: This is a novel approach to manage oesophageal tubular duplication with minimal risk of mediastinal complications that would occur otherwise by a thoracic approach.