The automated washers were contaminated with a biofilm that rendered them resistant to decontamination. The washers then contaminated the endoscopes and bronchoscopes they were used to disinfect. Our institution purchased new endoscopes and a new paracetic acid sterilization system.
Results 694 patients (334 male, 340 female), median age 67 (range 21e99), 77% patients over 50. Endoscopy was visually normal in 45%, the commonest visual abnormalities were Oesophagitis (18%) and malignancy (13%). 23% of patients had biopsies. Suspected malignancy or BO were most likely to have biopsies taken (65% and 64% respectively), 9% visually normal endoscopies were biopsied. 83% (49 cases) with suspected malignancy had histological correlation, 17% (11 cases) had BO or Oesophagitis. Three patients were found to have malignancy where the visual diagnosis had been Oesophagitis or benign stricture. Both BO and Oesophagitis had >80% correlation visually and histologically. Six cases of EO were found, all were visually normal. One suspected case was seen at endoscopy, this was histologically normal. Conclusion There was generally good correlation between visual and endoscopic diagnosis, particularly in malignancy, however biopsy number was lower than expected. Failure to biopsy may lead to missed diagnosis of cancer or dysplasia. All cases of EO in adults had normal endoscopy, few patients with dysphagia and normal endoscopy had biopsies taken. EO may be commoner than suspected, true rates are unknown and a high index of suspicion is needed. We should carry out more endoscopies on younger patients with symptoms in keeping with EO and biopsy normal oesophagus in cases where this diagnosis is suspected.
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