Peptic Esophageal Stenosis vs. Vascular Ring Anomaly
Left picture: The boy has not a psychic disorder, but a peptic esophageal stenosis in a complicated gastroesophageal reflux. Instead of the vomiting, which had been present since birth, dysphagia, regurgitation, and halitosis are now present. Right picture: Here, the diagnosis is a vascular ring anomaly of the type of a double aortic arch, which led to a compression of the esophagus and the described symptoms. Besides a lateral picture during a contrast study of the esophagus, additonal radiological examinations such as CT with contrast etc. are necessary for the description of the type of vascular ring anomaly.
Left picture: Sector of a contrast study in a 9-year-old boy with choking and bringing up during eating for some time already. The whole family is under stress. At the site of transition from the middle third of the esophagus to the distal third a stenosis is visible along at least the length of 1.5 vertebral body heights. Compare the normal calibre of the distal esophagus with that of the proximal part. Right picture: In this 3-month-old girl a disorder of feeding has existed since birth with long feeding times, choking and bringing up with increasing consistency of the feeds. The esophagus, which is demonstrated in its whole length by contrast, proceeds twisted s-like downstream from the thoracic apperture.