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Gastroenterology
Published in Paul Bentley, Ben Lovell, Memorizing Medicine, 2019
Intrinsic: Upper: Pharyngeal pouchPost-cricoid webMiddle: OesophagitisOesophageal strictureOesophageal carcinomaLower: Hiatus herniaSchatzki ring
Abnormal Anatomy of the Esophagus
Published in John F. Pohl, Christopher Jolley, Daniel Gelfond, Pediatric Gastroenterology, 2014
Razan Alkhouri, Rafal Kozielski, Daniel Gelfond
Rings and webs may be congenital remnants in which the esophagus fails to recanalize completely during embryogenesis. Schatzki rings arise in response to chronic injury by gastroesophageal reflux. Autoimmune diseases have been associated with esophageal webs and rings. Although webs have been linked to iron deficiency anemia (Plummer–Vinson syndrome), some studies have found no correlation between webs and either overt or latent iron deficiency.
Gastroenterology and hepatology
Published in Shibley Rahman, Avinash Sharma, A Complete MRCP(UK) Parts 1 and 2 Written Examination Revision Guide, 2018
Shibley Rahman, Avinash Sharma
Some important points regarding dysphagia to remember are: The obstruction usually is perceived at a point that is either above or at the level of the lesion.Dysphagia for solids and liquids simultaneously should alert the clinician to the possibility of a motility disorder such as achalasia.Dysphagia secondary to ‘a Schatzki ring’ usually is intermittent and nonprogressive.Dysphagia for solids and liquids early in the course of disease should alert the clinician to the possibility of achalasia as an aetiology.Benign oesophageal strictures usually produce dysphagia with slow and insidious progression (i.e. months to years) of frequency and severity with minimal weight loss.Malignant oesophageal strictures result in a rapid progression (i.e. weeks to months) of severity and frequency of dysphagia and are associated frequently with significant weight loss.Determining whether the patient takes any medications known to cause oesophagitis is important.Determining whether a history of collagen vascular disease or immunosuppression exists may provide clues to the underlying aetiology.
Efficacy of bougie dilation for normal diet in benign esophageal stricture
Published in Scandinavian Journal of Gastroenterology, 2023
Jun Young Park, Jae Myung Park, Ga-Yeong Shin, Joon Sung Kim, Yu Kyung Cho, Tae Ho Kim, Byung-Wook Kim, Myung-Gyu Choi
Esophageal stricture is an abnormal narrowing of the esophageal lumen. The most common symptom associated with esophageal stricture is difficulty in swallowing solid foods [1–3]. Benign esophageal stricture (BES) is caused by mucosal injury such as reflux esophagitis, post-radiation therapy, ingestion of corrosive agents, post-endoscopic procedure or -surgery [4]. Among them, peptic stricture is the most common cause of benign esophageal strictures, which account for about 70% of cases. Endoscopic treatment is known to be effective for peptic stricture [5]. However, the increasing use of proton pump inhibitors (PPIs) has led to a relative decrease in their incidence [1]. Nowadays, esophageal strictures from malignancy, post-surgery, caustic ingestion, radiation therapy, wide mucosectomy, eosinophilic esophagitis and Schatzki rings are increasingly encountered [1,6].
Effectiveness of esophagogastroduodenoscopy in changing treatment outcome in refractory gastro-esophageal reflux disease
Published in Scandinavian Journal of Gastroenterology, 2022
Ye Eun Kwak, Ahmed Saleh, Ahmed Abdelwahed, Mayra Sanchez, Amir Masoud
Among all the patients who underwent EGD for refractory GERD symptoms, most patients had completely normal endoscopic esophageal findings (150/301, 49.8%), or benign and/or incidental findings (101/301, 33.6%). Benign findings included hiatal hernia (73/301, 24.3%), grade A–B esophagitis (21/301, 7.0%), ulcer (1/301, 0.3%), erosion (9/301, 3.0%) and erythema (7/301, 2.3%). Incidental findings included Schatzki ring (8/301, 2.7%), glycogenic acanthosis (2/301, 0.7%) or biopsy-proven benign hyperkeratosis related polypoid lesions (3/301, 1.0%). Patients who had endoscopic findings suspicious for intestinal metaplasia were 16.3% (49/301) which included irregular z line (35/301, 11.6%) and salmon-colored mucosa (21/301, 7.0%). All the endoscopic findings were not significantly different between patients who were on PPI and who were not on PPI (p > .05) except that people on PPI had more small hiatal hernia compared to people who were not on PPI (23.3 vs 8.9%, p = .017, Table 2).
Esophageal foreign bodies in adults: systematic review of the literature
Published in Scandinavian Journal of Gastroenterology, 2018
Alberto Aiolfi, Davide Ferrari, Carlo Galdino Riva, Francesco Toti, Gianluca Bonitta, Luigi Bonavina
Overall, 40 studies (7541 patients) reported the location of the impacted FB. There were 5044 FB impacted in the cervical esophagus (66.9%), 1862 in the thoracic esophagus (24.7%) and 635 in the lower esophagus (8.4%). The most commonly reported symptoms were retrosternal pain (78%), dysphagia (48%) and odynophagia (43.4%) (Table 3). Respiratory symptoms were reported in 4% of patients, and 3.1% of patients were asymptomatic at hospital admission. An underlying esophageal disorder was diagnosed in 1872 of 7280 (25.7%) patients (26 studies). The most commonly associated esophageal disorders were stricture (33.9%), hiatus hernia (20.2%) and esophageal web or Schatzki ring (17.1%). Eosinophilic esophagitis was diagnosed at the time of presentation in 9.5% of patients.