High peptic stricture of the oesophagus.

Abstract

Davidson, J. S. (1976). Thorax, 31,[1][2][3][4][5][6][7][8][9][10][11][12][13][14]. High peptic sticture of the oesophagus. Fifty-seven patients with high peptic stricture and the lower oesophagus lined by columnar epithelium are considered from the clinical point of view. Information from 115 cases of low stricture is introduced for comparison. The average age of adult patients was 62 years with a sex incidence of 36 females to 21 males. There is little difference between the symptoms of high and low strictures. Radiologically, the majority of high strictures are short and smooth but other types are illustrated. Carcinoma and congenital mid-oesophageal web are considered in the differential diagnosis. There was an associated duodenal ulcer in 10% of cases. In six patients, a high stricture developed soon after an abdominal operation or period of recumbency. Two patients are illustrated showing the process of stricture formation. Four patients are described who had gastric-lined oesophagus but no ulceration or stricture. One patient had a Barrett ulcer in addition to a high stricture. A patient is described in whom the mucosa of the lower oesophagus appeared to be replaced by jejunal mucosa following oesophagojejunostomy. One patient is illustrated in whom a stricture was seen to ascend the oesophagus over a period of six years. Thirty-three patients were treated by dilatation and 24 by operation. Hernial repair is an effective form of treatment. Of 19 patients treated in this way, significant dysphagia persisted in two and slight dysphagia in one. The clinical findings are discussed in relation to the origin of columnar epithelium in the oesophagus.

Η Αξία Της Ενδοσκοπικής Βιοψίας Στη Διάγνωση Των Στενώσεων Του Οισοφάγου

“…Φαίνεται πάντως ότι τα ευρήματα αυτά όταν υπάρχουν ισχυρο ποιούν την διάγνωση της οισοφαγίτιδας από παλινδρόμηση όπως έ χουν δείξει κλινικές (Behar fj Sheahan 1975, Johnson et al 1978, Leape et al 1981, Bremner 1982, Teilum 1982 Η διάγνωση της οισοφαγίτιδας από παλινδρόμηση και της φύσεως'.της στενώσεως που αναπτύσσεται στους αρρώστους αυτούς τίθε ται με ενδοσκόπηση και πολλαπλές βιοψίες του οισοφαγικού επιθη λίου και τής περιοχής της στενώσεως που είναι μέθοδος σαφώς πιο αξιόπιστη από τον ακτινολογικό έλεγχο (Ott et al 1979, Aprig'liano 1980, Reed 1980, Benzamin et al 1980, Loygue et al 1980, Herbst 1981, Bremner 1982, Teilum 1982., Creteur et al 1983 , Menguy 1979. Il συχνότητα της στο υλικό ενδοσκοπικών βιο ψιών από το ανώτερο πεπτικό κυμαίνεται από 0,6-4% (Naef et al 1975, Dees et al 1978, Burdige & Radigan 1979 (Stillman & Selwyn 1975, Cho et al 1975, Bozymski et al 1982, Bremner 1982, Levine et al 1983, Sjogren & Johnson 1983, Berardi & Devaiah 1983 , Halvorsen & Semb 1975, Davidson 1976, Henrion 1979, Vieux et al 1981, Gelzayd & Maas 1981, Saltzman et al 1982, Iascone et al 1983 , Mangia et al 1976, Luciano et al 1977, Wesdorp et al 1981, Kothari et al 1980…”