To evaluate the application value of endoscopic ultrasound in the diagnosis and treatment of upper gastrointestinal stenosis in children.

A total of 48 children with upper gastrointestinal stenosis admitted to Children's Hospital Affiliated to Shandong University from May 2015 to May 2020 were analyzed retrospectively. There were 27 cases of esophageal stricture (18 cases of anastomotic stricture after surgical correction of esophageal atresia, 3 cases of chemically corrosive stricture, 1 case of esophageal stricture caused by foreign body, 5 cases of esophageal stricture of unknown etiology), 4 cases of achalasia, 12 cases of gastric output stricture, and 5 cases of duodenal stricture. All the children were evaluated by endoscopic ultrasonography before surgery under anesthesia, and different treatment plans were selected according to the stenosis site of upper gastrointestinal tract, stenosis opening size and endoscopic ultrasonography changes.

Endoscopic ultrasonography showed that the boundary of esophageal wall layer was not clear, and the thickness of the wall around the annular stenosis was uneven in 18 children with anastomotic stricture after surgical correction of esophageal atresia. Endoscopic ultrasonography showed different degree of esophageal injury in 3 children with corrosive esophageal injury. Endoscopic ultrasonography showed echo of foreign body in 1 child with esophageal stenosis caused by foreign body. Endoscopic ultrasonography showed unclear stratification of esophageal wall in 5 children with unexplained esophageal stenosis. Endoscopic ultrasonography showed that the thickness of cardia proper muscle layer was 0.9-4.0 mm in 4 children with achalasia. Endoscopic ultrasonography showed that the level of stenosis was not clear and the thickness was uneven in 12 children with gastric output stenosis. Among the 5 cases of duodenal stenosis, 4 cases of congenital dysplasia showed homogeneous echo in local tissues at the stenosis site by endoscopic ultrasonography, the other case was duodenal stricture caused by peptic ulcer, and endoscopic ultrasonography showed that the pyloric mucosa eminence was blurred.

Endoscopic ultrasound can accurately discover the origin and level of upper gastrointestinal stenosis in children, contribute to diagnosis and preoperative risk assessment, and provide an important basis for the selection of treatment plan.