Peptic esophageal stricture: a report from Argentina

• Published in: Diseases of the esophagus 2004-01, Vol.17 (1), p.63-66
• Main Authors: Mazzadi, Sergio Angel, García, Alfredo Omar, Salis, Graciela Beatriz, Chiocca, Juan Carlos
• Format: Article
• Language: English
• Subjects: Adult; Age Distribution; Aged; Argentina - epidemiology; benign esophageal stenosis; Catheterization - methods; Cohort Studies; esophageal bougienage; Esophageal Stenosis - diagnosis; Esophageal Stenosis - epidemiology; Esophageal Stenosis - etiology; Esophageal Stenosis - therapy; Esophagoscopy; Female; Gastroesophageal Reflux - complications; Humans; Incidence; Male; Manometry; Middle Aged; peptic esophageal stenosis; Prognosis; Retrospective Studies; Severity of Illness Index; Sex Distribution; Statistics, Nonparametric; Treatment Outcome
• ISSN: 1120-8694; 1442-2050
• DOI: 10.1111/j.1442-2050.2004.00375.x

Peptic esophageal stricture (PES) is a major complication of gastroesophageal reflux disease. The aims of this paper were to determine the characteristics of these patients with regard to demography, morphology, functional status and results of therapy. The charts of the patients treated at our service who underwent esophageal dilatation for PES between 1971 and 1998 were reviewed. Statistical analyses were performed by means of χ2, Mann–Whitney and Student's t‐tests. One hundred and thirty‐five patients with PES were dilated by various means. The mean age was 61.1 ± 16.3 years, the ratio of men to women was 2.75/1 and mean duration of symptoms was 44.4 ± 74.6 months. Their symptoms were dysphagia in 100%, pyrosis in 70%, and regurgitation in 40% of the cases. There was an average weight loss of 3.3 ± 6 kg. The upper gastro‐intestinal series showed pre‐ and post‐dilatation diameters at the stricture of 8 ± 2.5 mm and 15.9 ± 1.2 mm, respectively. The stricture was located at the lower third of the esophagus in 97% and at the middle third in 3% of the cases. We found PES endoscopically in all instances, with different degrees of erosions in 64%, ulcers in 20% and Barrett's esophagus in 16% of the cases. The biopsy samples showed intestinal metaplasia in 16% and esophagitis in 75.5%, being normal in the remaining 8.5%. Brush cytology was negative for malignancy in 100% of the cases. Esophageal manometry showed peristaltic wave amplitude of 40 ± 3 mmHg and presence of peristaltic waves of 62 ± 38.6%. LES pressure was 8.6 ± 6.3 mmHg (NV 24.2 ± 6.3 mmHg). Measurement of pH showed 15% of patients had pH