Non-specific oesophagitis is well recognized as a sequel to operations for the relief of cardiospasm and in association w:th hiatus hernia (Belsey, 1953). The frequency with which oesophagitis occurs in general hospital practice is, however, not widely appreciated. This is probably due mainly to the mildness or absence of symptoms in many cases of oesophagitis. The purpose of the present paper is to stress the frequency of the lesion, particularly as a result of confinement to bed, and to suggest the gravity of the possible clinical sequelae if the condition is unrecognized and untreated.
METHODThe findings are based on the examination of the oesophagi from 500 unselected hospital necropsies, and on a similar review of the oesophagi from 100 cases of sudden death. Patients in the latter group had been in apparently good health until the onset of their fatal illnesses, which lasted not longer than 24 hours. Some were the victims of industrial or road accidents; others collapsed and died in the street or at work. From the pathological aspect, whether there was evidence of oesophagitis macroscopically or not, blocks of the oesophagus were examined microscopically.Clinically the case history of each patient was reviewed to determine the relationship between oesophagitis and a number of factors considered of importance by previous writers.
RESULTSIn the 500 hospital patients the incidence of oesophagitis was 36 %, composed of 31 % showing an acute lesion and 5 % with chronic oesophagitis. Grouping the cases into three arbitrarily decided grades of severity (Lodge, 1955), 20.5% of the lesions were of the most advanced type with widespread destruction of the oesophageal mucosa and inflammation extending into the muscularis externa. In the " sudden death " series 8 % had oesophagitis, composed of 3% showing an acute lesion and 5% chronic oesophagitis with fibrosis of the wall.