Presentation
We report 6 new cases of congenital esophageal stenosis (CES) that presented to us with special diagnostic and management problems and review the literature on this subject. [ncbi.nlm.nih.gov]
Left: 50 year-old woman, with a history of lye ingestion in childhood, who presented with dysphagia (difficulty swallowing). [endoatlas.com]
Entire Body System
- Weight Loss
We report a case of a 56-year-old woman with a history of allogenic bone marrow transplantation for two years, complaining with dysphagia and weight loss. Upper endoscopy revealed esophageal stenosis and extensive mucosa sloughing. [ncbi.nlm.nih.gov]
The main symptoms include: difficulty swallowing food coming back up the throat from the stomach unintentional weight loss There are several different treatment options for benign esophageal strictures, including: Taking medications to reduce stomach [medicalnewstoday.com]
Typical symptoms include; Dysphagia: Odynophagia unintended weight loss regurgitation of food or liquids: Heartburn Choking Bad taste in mouth hiccups 12. Barium Swallow Esophageal PH monitoring CT Scan Endoscopy Biopsy 13. Heart burn [slideshare.net]
- Malnutrition
Symptoms of esophageal strictures include: Difficult or painful swallowing Food feeling stuck in the throat Food coming back up the throat from the stomach Frequent hiccupping or burping Coughing or choking Heartburn Unintentional weight loss and malnutrition [lluh.org]
Heart burn Malnutrition Dehyadration Choking Aspiration Pneumonia 14. On the left images of a patient with a benign stricture high in the esophagus (arrow). [slideshare.net]
The incidence of protein-calorie malnutrition of early childhood. Am J Public Health 1963;53:905-12. 21. Gurney JM, Jelliffe DB. [redalyc.org]
[…] following symptoms: swallowing becoming difficult or painful food feeling stuck in the throat food returning up to the mouth from the stomach unintentional weight loss heartburn frequent hiccupping or burping coughing or choking drooling dehydration or malnutrition [medicalnewstoday.com]
- Asymptomatic
[…] primary surgical intervention (4/9 were asymptomatic at follow-up). [ncbi.nlm.nih.gov]
After 2 years of follow-up, the patient was fully asymptomatic without major abnormalities on esophagoscopy and barium esophagogram images. [jdeonline.in]
- Mucosal Edema
Top of page Physical Findings Although LPR has been associated with multiple otolaryngologic disorders, the most common physical findings of LPR are related to laryngeal mucosal edema and injury. [nature.com]
Gastrointestinal
- Dysphagia
CONCLUSION: Pharyngeal and/or cervical esophageal stenosis may be the cause of dysphagia following radiation for head and neck cancer. Esophageal dilatations often offer temporary relief of the dysphagia. [ncbi.nlm.nih.gov]
- Dysphagia
CONCLUSION: Pharyngeal and/or cervical esophageal stenosis may be the cause of dysphagia following radiation for head and neck cancer. Esophageal dilatations often offer temporary relief of the dysphagia. [ncbi.nlm.nih.gov]
- Regurgitation
Symptoms were solid food refusal, regurgitation, vomiting, and dysphagia. Congenital esophageal stenosis was located in the distal esophagus. Endoscopic ultrasonography demonstrated TBR and FMH in 6 patients. [ncbi.nlm.nih.gov]
There is also a higher risk of having food, fluid, or vomit enter the lungs with regurgitation. This can cause choking or aspiration pneumonia. [nicklauschildrens.org]
- Progressive Dysphagia
Right: Tight stricture at the esophagogastric junction in a 98 year-old woman who had complained of progressive dysphagia to solids. [endoatlas.com]
A 5-year-old girl with Stevens-Johnson syndrome developed progressive dysphagia secondary to esophageal stenosis. The authors resolved this by treating the patient with balloon dilatation. She has remained symptom-free for 10 months post-treatment. [ncbi.nlm.nih.gov]
dysphagia, may cause total obstruction Back to top [pathologyoutlines.com]
In another recent paper (Weston, Thosani, Bektas, Oruc, & Bhutani, 2010), a 79-year-old male patient who presented with progressive dysphagia and had endoscopic and ultrasound findings compatible to esophageal cancer was found to have esophageal stricture [nursingcenter.com]
Case Report An eleven-year old boy presented in our hospital outpatient department with a complaint of significant progressive dysphagia since last 2 years associated with regurgitation of food particles recently without history of significant weight [omicsonline.org]
- Persistent Vomiting
Due to the loss of hydrochloric acid in the gastric contents from persistent vomiting, patients are at risk of electrolyte imbalance, specifically the characteristic hypochloremic metabolic alkalosis. [radiopaedia.org]
Cardiovascular
- Vascular Disease
Populations at risk for Staphylococcus aureus infection Anyone can develop a staph infection, although certain groups of people are at greater risk, including people with chronic conditions such as diabetes, cancer, vascular disease, eczema, lung disease [cdc.gov]
Anyone can develop a staph infection, but certain people are at greater risk, including those who Have a chronic condition such as diabetes, cancer, vascular disease, eczema, and lung disease Have a weakened immune system, such as from HIV/AIDS, medicines [medlineplus.gov]
Anyone can develop a staph infection, although certain groups of people are at greater risk, including newborn infants, breastfeeding women, and people with chronic conditions such as diabetes, cancer, vascular disease, and lung disease. [medicinenet.com]
Background Disease processes that can produce esophageal strictures can be grouped into three general categories: (1) intrinsic diseases that narrow the esophageal lumen through inflammation, fibrosis, or neoplasia; (2) extrinsic diseases that compromise [emedicine.medscape.com]
- Heart Disease
Other malformations may be present, such as anorectal malformations, congenital heart disease, trisomy 21, microphthalmia with coloboma of iris, atresia or duodenal duplication, malrotation, Meckelâ€(tm)s diverticulum, celiac disease, microgastria, diaphragmatic [scielo.br]
Relatively frequent anomalies were as follows; congenital heart disease (4.5%), 21trisomy (4.0%), anorectal anomaly (2.0%), duodenal atresia (1.5%), tracheal malacia (1.5%), esophageal hiatal hernia (1.0%). [wjgnet.com]
Workup
Further workup was not pursued, as the patient refused initial endoscopy. [acgcasereports.gi.org]
Being selective with the diagnostic workup is essential, and appropriate, timely referrals to an endoscopist merit consideration. [ncbi.nlm.nih.gov]
Treatment
Descriptions of surgical techniques are included, as well as a discussion of potential complications of treatment modalities. [jhu.pure.elsevier.com]
Inappropriate treatment often is carried out before the correct diagnosis is established. [ncbi.nlm.nih.gov]
Novel treatment modalities for refractory strictures include temporary stent placement and incisional therapy. [nature.com]
Prognosis
Multivariable analyses indicated only esophageal stenosis as a common factor for poor prognosis. In addition, overall survival tended to decrease according to the GPS subgroups (median survival time (months): GPS0/GPS1/GPS2 16.1/14.9/8.7). [ncbi.nlm.nih.gov]
Nevertheless, there have been reported certain cases where differentiation from malignancy was tricky, yet prognosis diverged significantly. [nursingcenter.com]
Treatment and prognosis The risk of Barrett esophagus in stricture is 20-40% and strictures should be evaluated endoscopically. [radiopaedia.org]
Outlook (Prognosis) The stricture may come back in the future. This would require a repeat dilation. Possible Complications Swallowing problems may keep you from getting enough fluids and nutrients. [nicklauschildrens.org]
Prognosis .—It is unfavorable in the large majority of cases. Where, there is but little structural change, repeated dilatation will effect a cure. Treatment .—It is very doubtful if medicines produce any influence on this unfortunate condition. [henriettes-herb.com]
Etiology
EUS was useful for determining the etiology of esophageal stenosis and, thus, the appropriate treatment strategy. [ncbi.nlm.nih.gov]
The length of stricture was longer (p=0.040) and the number of therapeutic sessions were increased (p=0.026) in corrosive stricture than other etiologies. [kci.go.kr]
Epidemiology
Structures every chapter consistently to include Findings, Imaging Modalities, Clinical Presentation, Pathology, Incidence/Prevalence and Epidemiology, What the Referring Physician Needs to Know, Suggested Readings, and Selected Images to make reference [books.google.com]
Epidemiology[edit] Gastroesophageal reflux disease (GERD) affects approximately 40% of adults. [en.wikipedia.org]
Staphylococcus aureus infections: epidemiology, pathophysiology, clinical manifestations, and management. Clin. Microbiol. Rev. 2015 Jul; 28 (3):603-61. [ PMC free article : PMC4451395 ] [ PubMed : 26016486 ] 7. DeLeo FR, Diep BA, Otto M. [ncbi.nlm.nih.gov]
Diagnosis and management Submit data Epidemiology PHE has carried out mandatory enhanced surveillance of MRSA bacteraemia since October 2005 and of MSSA bacteraemia since January 2011 for NHS acute trusts; patient-level data of any MRSA and MSSA bacteraemias [gov.uk]
The Changing Epidemiology of Staphylococcus aureus [17 paragraphs]. Medscape Today [On-line article from Emerg Infect Dis 7(2), 2001]. Available FTP: http://www.medscape.com/viewarticle/414383 S15 (2004 March 16). [labtestsonline.cz]
Pathophysiology
We discuss the pathophysiology, clinical presentation, differential diagnosis, and multidisciplinary management of peptic esophageal strictures. This case illustrates the difficulty in managing high peptic strictures. [ncbi.nlm.nih.gov]
Newborn Surgery, Third Edition provides a comprehensive compendium of the pathophysiology, investigation and management of neonatal disorders. [books.google.com]
This suggests that differences in pathophysiology between LPR and GERD patients are part of the basis for the contrasting symptomology. [nature.com]
PATHOPHYSIOLOGY: • Benign esophageal stricture describes a narrowing or tightening of the esophagus. • Benign esophageal stricture typically occurs when stomach acid and other irritants damage the lining of the esophagus over time. • This leads to inflammation [slideshare.net]
Prevention
CONCLUSION: Biodegradable stents were useful for the treatment of benign esophageal stenosis, particularly for the prevention of post-ESD stenosis. [ncbi.nlm.nih.gov]
They may also recommend them for long-term treatment to prevent recurrence. [healthline.com]