Eosinophilic Esophagitis: Analysis of Food Impaction and Perforation in 251 Adolescent and Adult Patients

Straumann, Alex; Bussmann, Christian; Zuber, Markus; Vannini, Simone; Simon, Hans‐Uwe; Schoepfer, Alain

doi:10.1016/j.cgh.2008.02.003

Cited by 219 publications

(173 citation statements)

References 14 publications

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“…It is well established that strictures contribute to symptom generation as well as occurrence of potentially dangerous food bolus impactions. [17,22] In Switzerland, approximately 250 board-certified gastroenterologists, working in university hospitals, general hospitals and private practices provide gastroenterological care.…”

Section: Discussionmentioning

confidence: 99%

Delay in Diagnosis of Eosinophilic Esophagitis Increases Risk for Stricture Formation in a Time-Dependent Manner

Schoepfer

Safroneeva

Bussmann³

et al. 2013

Gastroenterology

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Section: Discussionmentioning

confidence: 99%

Delay in Diagnosis of Eosinophilic Esophagitis Increases Risk for Stricture Formation in a Time-Dependent Manner

Schoepfer

Safroneeva

Bussmann³

et al. 2013

Gastroenterology

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619

517

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“…It also provides relief for patients whose symptoms have not responded to therapy with steroids, and those who do not want to be on long term medications or significantly restrict their diets [1,3,17] . Early descriptions of routine endoscopies and therapeutic interventions, such as dilation, in EoE patients indicated that the fragile and inelastic mucosa associated with the disease increased risks of deep tissue tears, lacerations, and perforations [4,11,12,14,18] . However, more recent studies with larger patient samples have indicated esophageal dilation as a safe therapy in EoE patients [16,[19][20][21] .…”

Section: Introductionmentioning

confidence: 99%

Esophageal dilations in eosinophilic esophagitis: A single center experience

Ukleja

Shiroky

Agarwal

et al. 2014

WJG

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AIM: To diagnose the clinical and histologic features that may be associated with or predictive of the need for dilation and dilation related complications; examine the safety of dilation in patients with eosinophilic esophagitis (EoE). METHODS:The medical records of all patients diagnosed with EoE between January 2002 and July 2010 were retrospectively reviewed. Esophageal biopsies were reexamined by an experienced pathologist to confirm the diagnosis (≥ 15 eos/hpf per current guidelines). Patients were divided into 2 groups: patients who did not receive dilation therapy and those who did. Demographics, clinical history, the use of pharmacologic therapy, endoscopic and pathology findings, and the number of biopsies and dilations carried out, if any, and their locations were recorded for each patient. The dilation group was further examined based on the interval between diagnosis and dilation, and whether or not a complication occurred. RESULTS:Sixty-one patients were identified with EoE and 22 (36%) of them underwent esophageal dilations for stricture/narrowing. The peak eos/hpf was significantly higher in patients who received a dilation (P = 0.04). Four (18% of pts.) minor complications occurred: deep mucosal tear 1, and small mucosal tears 3. There were no cases of esophageal perforations. Higher peak eos/hpf counts were not associated with increased risk of complications. CONCLUSION:Esophageal dilation appears to be a safe procedure in EoE patients, carrying a low complication rate. No correlation was found between the peak of eosinophil count and complication rate. Complications can occur independently of the histologic features. The long-term outcome of EoE treatment, with or without dilation, needs to be determined. © 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Balloon dilation; Dysphagia; Esophagus disorder; Esophageal stricture; Esosinophilic esophagitis Core tip: The field of gastroenterology does not currently have standardized treatment guidelines for eosinophilic esophagitis. Current data on the safety of dilations in patients with eosinophilic esophagitis (EoE) are conflicting and lack information on factors that influence whether or not a patient will require dilation. This study revealed that higher peak eos/hpf counts appear to influence whether or not an EoE patient will require dilation during the course of their treatment. However, complications appear to occur independently of the histologic features. Esophageal dilation appears to be a safe procedure in EoE patients, carrying a low complication rate.

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“…Perforation may occur in less than 0.04% of the diagnostic upper GI endoscopy, and is usually associated to operator inexperience and some patient-related risk factors, such as: cervical osteophytosis, Zenker's or duodenal diverticulum, pharyngeal pouches, malignant/benign strictures and eosinophilic oesophagitis [9][10][11][12]. In colonoscopy the risk of perforation ranges from 0.11% in diagnostic, up to 10% in therapeutic procedures [6,[13][14][15].…”

Section: Perforationmentioning

confidence: 99%

Emergencies after endoscopic procedures

Rolanda

Caetano

Dinis-Ribeiro

2013

Best Practice & Research Clinical Gastroenterology

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Keywords:GI endoscopy adverse events GI emergencies Bleeding Haemorrhage Perforation Infection Embolization Diagnosis and management of severe complications a b s t r a c t Endoscopy adverse events (AEs), or complications, are a rising concern on the quality of endoscopic care, given the technical advances and the crescent complexity of therapeutic procedures, over the entire gastrointestinal and bilio-pancreatic tract. In a small percentage, not established, there can be real emergency conditions, as perforation, severe bleeding, embolization or infection. Distinct variables interfere in its occurrence, although, the awareness of the operator for their potential, early recognition, and local organized facilities for immediate handling, makes all the difference in the subsequent outcome. This review outlines general AEs' frequencies, important predisposing factors and putative prophylactic measures for specific procedures (from conventional endoscopy to endoscopic cholangio-pancreatography and ultrasonography), with comprehensive approaches to the management of emergent bleeding and perforation.

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Eosinophilic Esophagitis: Analysis of Food Impaction and Perforation in 251 Adolescent and Adult Patients

Cited by 219 publications

References 14 publications

Delay in Diagnosis of Eosinophilic Esophagitis Increases Risk for Stricture Formation in a Time-Dependent Manner

Delay in Diagnosis of Eosinophilic Esophagitis Increases Risk for Stricture Formation in a Time-Dependent Manner

Esophageal dilations in eosinophilic esophagitis: A single center experience

Emergencies after endoscopic procedures

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