Unusual complications of oesophageal ulcers

Johnson, C. D.

doi:10.1136/pgmj.64.755.656

Postgraduate Medical Journal

1988

DOI: 10.1136/pgmj.64.755.656

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Unusual complications of oesophageal ulcers

C. D. Johnson

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1994

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Cited by 2 publications

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“…A PI ITI IOUS ESOPHAGEAL ULCERS are rare. T hey have been described in Be hc;:er's d isease (1 -4 ), ulcerative colitis ( UC) (5,6), yersinia ente ritis (7), ame biasis (8,9) and Crohn's disease (CD) (10)(11)(12)(13)(14)(15)(16)(17)(18)(19). There have been fe we r than 60 cases of esophageal ulcers in CD reported in the lite rature fro m 1950-93.…”

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confidence: 99%

Aphthous Esophagael Ulceration: A Novel Presentation of Crohn’s Disease?

Beck

Blustein

Andersen

1994

Canadian Journal of Gastroenterology

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Crohn’s disease (CD) commonly presents as involvement of the small bowel or colon - the esophagus is rarely involved. The authors describe the case of a 45-year-old woman who presented with odynophagia and was found to have aphthous ulcers of the esophagus. On questioning, she admitted to three to four episodes of nonbloody diarrhea, each lasting less than one week, over the past two years. The patient denied other symptoms of gastrointestinal, collagen-vascular, respiratory or cardiovascular disease. Viral, fungal and bacterial cultures of blood, stool and tissue biopsies were all negative. A small bowel enema showed inflammation of the distal ileum. Colonoscopy revealed patchy areas of inflammation of the colon and distal ileum. Biopsies from the esophagus, duodenum, terminal ileum and colon showed chronic inflammation, lymphoid aggregates, goblet cell hyperplasia (in the colon) and crypt abscesses. Giant cells, granulomas and fissures were not evident in any of the biopsies. The patient failed to respond to a three-week course of omeprazole, but her symptoms resolved within three days of starting prednisone. The exact cause of the esophageal ulcerations is unknown but most likely is CD of the esophagus.

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confidence: 99%

Aphthous Esophagael Ulceration: A Novel Presentation of Crohn’s Disease?

Beck

Blustein

Andersen

1994

Canadian Journal of Gastroenterology

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Real world management of esophageal ulcers : analysis of their presentation, etiology, and outcomes

Cohen¹,

Bermont²,

Richter³

et al. 2021

AGEB

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Background and study aims : Esophageal ulcers are a rare cause of upper gastrointestinal morbidity and may be due to different etiologies. We sought to systematically evaluate patients with esophageal ulcers and describe their presentations, endoscopic findings, etiologies, treatments, and outcomes. Patients and methods : Patients diagnosed with esophageal ulcers over an 11-year period were retrospectively identified from our institution’s electronic medical records. Results : We identified 100 patients with esophageal ulcers (0.49% of patients undergoing upper endoscopy). Half of them presented due to gastrointestinal bleeding and three-quarters were admitted to the hospital. The majority were in the lower esophagus. Twenty-two unique etiologies, including multiple iatrogenic causes, were diagnosed in 91 of the cases. The most common etiology was gastroesophageal reflux disease (57%), followed by non-steroidal anti-inflammatory drug use (7%), malignancies (3%), vomiting (3%), caustic ingestion (2%), pill esophagitis (2%) and radiation (2%). Many etiologies showed a predilection for specific segments of the esophagus. Nine ulcers required endoscopic intervention and all were treated successfully. Repeat endoscopies were performed 5 times for diagnostic or “second look” reasons, none of which changed the patients’ diagnosis or treatment. No patients required surgery or stricture dilation. One patient’s ulcer was complicated by perforation and he subsequently died. Four other patients died from non-ulcer related causes. Conclusions : While the majority of ulcers were due to gastro-esophageal reflux disease, 22 different etiologies were identified. Many were due to medication or iatrogenic causes. Repeat endoscopy did not appear to be helpful. While the incidence was low, they were frequently associated with significant morbidity.

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Unusual complications of oesophageal ulcers

Cited by 2 publications

References 17 publications

Aphthous Esophagael Ulceration: A Novel Presentation of Crohn’s Disease?

Aphthous Esophagael Ulceration: A Novel Presentation of Crohn’s Disease?

Real world management of esophageal ulcers : analysis of their presentation, etiology, and outcomes

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