Sharp recanalization of an esophageal occlusion after repair of esophageal atresia and tracheoesophageal stricture

Esophageal atresia with an associated tracheoesophageal fistula is a congenital anomaly requiring surgical correction. Recurrent stricture is the most common complication of surgical repair and is usually treated with mechanical dilation. Rarely, a recurrent completely obstructive stricture can cause obliteration of the anastomosis, preventing passage of a wire for dilation. This condition requires operative correction. In the case presented herein, the obliterated esophageal lumen from an obstructing stricture was operatively corrected with use of a novel transluminal technique. The obstruction was successfully crossed with a modified Chiba biopsy needle covered in a dilator through a gastrostomy. After subsequent balloon dilation, the lumen has remained patent for more than 3 years without significant complication.