Which of the following is a congenital anomaly among pediatric dysphagia etiologies?

• A. Congenital anomalies (laryngomalacia, tracheoesophageal fistula), esophageal atresia, feeding disorders, and CP dysfunction.
• B. Achalasia and esophageal cancer.
• C. GERD and peptic ulcers.
• D. Duodenal atresia and intussusception.

Answer: (A)

Pediatric dysphagia can arise from conditions present at birth that affect the structure of the airway and esophagus or from neurodevelopmental issues that disrupt swallow coordination. The best choice lists congenital anomalies known to cause swallowing difficulties in children: laryngomalacia (structural floppy larynx causing airway collapse that can complicate feeding), tracheoesophageal fistula (an abnormal connection between the trachea and esophagus that leads to choking or coughing with feeds), esophageal atresia (incomplete formation of the esophagus with feeding inability), along with feeding disorders and cerebral palsy (neurodevelopmental conditions that impair swallow coordination from early life). In contrast, achalasia and esophageal cancer are not typical pediatric congenital etiologies; GERD and peptic ulcers are acquired conditions, not congenital anomalies; duodenal atresia is congenital but usually presents with vomiting rather than dysphagia, and intussusception is not a common congenital cause of dysphagia.