Diseases of the oesophagus

2020 ◽  
pp. 2828-2848
Author(s):  
Rebecca C. Fitzgerald ◽  
Massimiliano di Pietro
Keyword(s):  
Reflux Disease ◽  
Malignant Disease ◽  
Clinical Symptoms ◽  
Stricture Formation ◽  
Benign Stricture ◽  
Muscular Layer ◽  
Hostile Environments ◽  
Upper Gastrointestinal ◽  
Conduit Function

Defective conduit function of the oesophagus readily induces clinical symptoms and may have serious effects on nutrition and the lungs, the latter resulting from aspiration of gastro-oesophageal contents. Oesophageal pain and dysphagia caused by diseases of the muscular layer or epithelium are often disabling. The oesophagus is exposed to numerous hostile environments including carcinogens in food or those derived from tobacco, betel nuts, and other ingested sources and hence carcinomas can occur. Chronic reflux disease from exposure to corrosive upper gastrointestinal secretions is also associated with malignant disease—adenocarcinoma—as well as benign stricture formation related to the action of pepsin.

Diseases of the oesophagus

2010 ◽  
pp. 2287-2304
Author(s):  
Rebecca Fitzgerald
Keyword(s):  
Clinical Symptoms ◽  
Malignant Diseases ◽  
Muscular Layer ◽  
Conduit Function

Defective conduit function of the oesophagus readily induces clinical symptoms and may have serious effects on nutrition and the lungs, the latter resulting from aspiration of gastro-oeophageal contents. Oesophageal pain and dysphagia caused by benign or malignant diseases of the muscular layer or epithelium are often disabling....

scholarly journals Fully-covered metal stents with endoscopic suturing vs. partially-covered metal stents for benign upper gastrointestinal diseases: a comparative study

2018 ◽  
Vol 06 (02) ◽  
pp. E217-E223 ◽  
Author(s):  
Saowanee Ngamruengphong ◽  
Reem Sharaiha ◽  
Amrita Sethi ◽  
Ali Siddiqui ◽  
Christopher DiMaio ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Stent Migration ◽  
Metal Stents ◽  
Stricture Formation ◽  
Endoscopic Suturing ◽  
Stent Removal ◽  
Gastrointestinal Conditions ◽  
Significant Difference ◽  
Stent Fixation ◽  
Upper Gastrointestinal

Abstract Background and study aims Self-expandable metallic stents (SEMS) have been increasingly used in benign conditions (e. g. strictures, fistulas, leaks, and perforations). Fully covered SEMS (FSEMS) were introduced to avoid undesirable consequences of partially covered SEMS (PSEMS), but come with higher risk of stent migration. Endoscopic suturing (ES) for stent fixation has been shown to reduce migration of FSEMS. Our aim was to compare the outcomes of FSEMS with ES (FS/ES) versus PSEMS in patients with benign upper gastrointestinal conditions. Patients and methods We retrospectively identified all patients who underwent stent placement for benign gastrointestinal conditions at seven US tertiary-care centers. Patients were divided into two groups: FSEMS with ES (FS/ES group) and PSEMS (PSEMS group). Clinical outcomes between the two groups were compared. Results A total of 74 (FS/ES 46, PSEMS 28) patients were included. On multivariable analysis, there was no significant difference in rate of stent migration between FS/ES (43 %) and PSEMS (15 %) (adjusted odds ratio 0.56; 95 % CI 0.15 – 2.00). Clinical success was similar [68 % vs. 64 %; P = 0.81]. Rate of adverse events (AEs) was higher in PSEMS group [13 (46 %) vs. 10 (21 %); P = 0.03). Difficult stent removal was higher in the PSEMS group (n = 5;17 %) vs. 0 % in the FS/ES group; P = 0.005. Conclusions The proportion of stent migration of FS/ES and PSEMS are similar. Rates of other stent-related AEs were higher in the PSEMS group. PSEMS was associated with tissue ingrowth or overgrowth leading to difficult stent removal, and secondary stricture formation. Thus, FSEMS with ES for stent fixation may be the preferred modality over PSEMS for the treatment of benign upper gastrointestinal conditions.

scholarly journals Corrosive injury of the upper gastrointestinal tract: the evolving role of a radiologist

2020 ◽  
Vol 93 (1114) ◽  
pp. 20200528
Author(s):  
Ayushi Agarwal ◽  
Deep Narayan Srivastava ◽  
Kumble Seetharama Madhusudhan
Keyword(s):  
Gastrointestinal Tract ◽  
Ct Scan ◽  
Upper Gastrointestinal Tract ◽  
Stricture Formation ◽  
Emergency Setting ◽  
Oral Contrast ◽  
Long Term Outcome ◽  
Corrosive Injury ◽  
Upper Gastrointestinal

Corrosive injury is a devastating injury which carries significant morbidity. The upper gastrointestinal tract is predominantly affected with severity ranging from mild inflammation to full thickness necrosis which may result in perforation and death. Among the complications, stricture formation is most common, causing dysphagia and malnutrition. Endoscopy has a pivotal role in the diagnosis and management, with a few shortcomings. Imaging has an important role to play. Besides radiography, there is an increasing role of CT scan in the emergency setting with good accuracy in identifying patients who are likely to benefit from surgery. Further, CT scan has a role in the diagnosis of complications. Oral contrast studies help in assessing the severity and extent of stricture formation and associated fistulous complications in the subacute and chronic phase. The scope of intervention radiology for this condition is increasing. Fluoroscopy-guided balloon dilatation, drainage of collections or mucoceles, endovascular embolization of point bleeders, placement of feeding jejunostomy and image-guided biopsy are among the procedures that are being performed. Through this review we aim to stress the role the radiologist plays in the diagnosis and follow-up of these patients and in performing radiological interventions. Besides this, we have also highlighted few salient points to help understand the pathophysiology and management of such injuries which is paramount to ensure a good long-term outcome.

scholarly journals Inkwelling increases benign stricture formation after Ivor Lewis esophagogastrectomy

2007 ◽  
Vol 133 (2) ◽  
pp. 581-582 ◽  
Author(s):  
Enoch Akowuah ◽  
Manfred Junemann-Ramirez ◽  
Odunayo Kalejayie ◽  
Joseph Rahamim
Keyword(s):  
Stricture Formation ◽  
Benign Stricture ◽  
Ivor Lewis
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