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The Medical Clinics of North America Jan 2019Eosinophilic esophagitis (EoE) is a chronic disorder characterized by symptoms of esophageal dysfunction and esophageal inflammation with intraepithelial eosinophils.... (Review)
Review
Eosinophilic esophagitis (EoE) is a chronic disorder characterized by symptoms of esophageal dysfunction and esophageal inflammation with intraepithelial eosinophils. EoE represents an important cause of upper gastrointestinal morbidity. Primary care providers are pivotal for timely and accurate recognition of symptoms of eosinophilic esophagitis, for facilitating diagnoses through specialist referrals, and for understanding management strategies. This process begins with a thorough understanding of the clinical features of EoE, its associated atopic conditions, and its evolving epidemiology.
Topics: Eosinophilic Esophagitis; Esophagoscopy; Esophagus; Female; Glucocorticoids; Humans; Male
PubMed: 30466674
DOI: 10.1016/j.mcna.2018.08.009 -
Revista Espanola de Enfermedades... Oct 2023Esophageal tuberculosis (ET) is an extremely rare disease and herein, we present an ET case. Endoscopic findings of ET are variable and diverse and can be easily...
Esophageal tuberculosis (ET) is an extremely rare disease and herein, we present an ET case. Endoscopic findings of ET are variable and diverse and can be easily mistaken for malignancy. A definitive diagnosis of ET is difficult to make with white light endoscopy alone, and the diagnostic yield of a biopsy is low in secondary ET cases with normal overlying mucosa. Although the findings of conventional endoscopy and endoscopic ultrasonography in ET have been reported so far, few reports have described the findings of magnifying endoscopy with narrow-band imaging (ME-NBI). Dilated microvessels without irregularities on ME-NBI may be useful to differentiate secondary ET from esophageal carcinoma, since the findings suggest compression from the depth. Although rare, ET has to be considered in the differential diagnosis for any unexplained esophageal lesions.
Topics: Humans; Esophagoscopy; Esophageal Neoplasms; Mucous Membrane; Biopsy; Narrow Band Imaging
PubMed: 36043542
DOI: 10.17235/reed.2022.9108/2022 -
Lancet (London, England) Jan 2014Achalasia is a rare motility disorder of the oesophagus characterised by loss of enteric neurons leading to absence of peristalsis and impaired relaxation of the lower... (Review)
Review
Achalasia is a rare motility disorder of the oesophagus characterised by loss of enteric neurons leading to absence of peristalsis and impaired relaxation of the lower oesophageal sphincter. Although its cause remains largely unknown, ganglionitis resulting from an aberrant immune response triggered by a viral infection has been proposed to underlie the loss of oesophageal neurons, particularly in genetically susceptible individuals. The subsequent stasis of ingested food not only leads to symptoms of dysphagia, regurgitation, chest pain, and weight loss, but also results in an increased risk of oesophageal carcinoma. At present, pneumatic dilatation and Heller myotomy combined with an anti-reflux procedure are the treatments of choice and have comparable success rates. Per-oral endoscopic myotomy has recently been introduced as a new minimally invasive treatment for achalasia, but there have not yet been any randomised clinical trials comparing this option with pneumatic dilatation and Heller myotomy.
Topics: Dilatation; Early Detection of Cancer; Esophageal Achalasia; Esophageal Neoplasms; Esophagoscopy; Humans; Manometry; Minimally Invasive Surgical Procedures; Precancerous Conditions; Recurrence
PubMed: 23871090
DOI: 10.1016/S0140-6736(13)60651-0 -
British Journal of Hospital Medicine... Jan 2023Achalasia, characterised by the absence of peristalsis and failure of relaxation of the lower oesophageal sphincter, is an uncommon degenerative condition that results... (Review)
Review
Achalasia, characterised by the absence of peristalsis and failure of relaxation of the lower oesophageal sphincter, is an uncommon degenerative condition that results in dysphagia. If left untreated it can lead to aspiration, oesophageal perforation, oesophagitis and malnutrition. It has a range of immune, allergic, viral and genetic aetiological causes. Successful diagnosis relies on the use of oesophagogastroduodenoscopy, barium swallow and oesophageal manometry to characterise the severity of the disease and to rule out underlying malignancy. Although no treatment can reverse the degenerative process, therapeutic strategies including lifestyle modification, medication, endoscopic and operative intervention can help to reduce symptoms. This article reviews the latest methods used to investigate and manage achalasia.
Topics: Humans; Esophageal Achalasia; Esophageal Sphincter, Lower; Deglutition Disorders; Manometry; Esophagoscopy
PubMed: 36708337
DOI: 10.12968/hmed.2022.0437 -
Ugeskrift For Laeger Jan 2023This is a classic case report of a rare giant fibrovascular polyp (GFP) of the oesophagus in a 50-year-old male patient, who two years prior had regurgitated the polyp...
This is a classic case report of a rare giant fibrovascular polyp (GFP) of the oesophagus in a 50-year-old male patient, who two years prior had regurgitated the polyp and swallowed it again. He only sought medical professionals after losing 25 kg and having severe dysphagia. The GFP, weight 520 g and size 21 × 9 × 7 cm, was removed in toto with a cervical excision following intraluminal marking of the base of the polyp during oesophagoscopy. On histological examination the GFP was found to represent a well-differentiated liposarcoma.
Topics: Male; Humans; Middle Aged; Esophageal Neoplasms; Esophagoscopy; Deglutition Disorders; Polyps
PubMed: 36636934
DOI: No ID Found -
The Journal of International Medical... Jul 2018Oesophageal foreign bodies (OFBs) are a relatively common emergency in young children. OFBs are complicated by significant morbidity and mortality because their...
Oesophageal foreign bodies (OFBs) are a relatively common emergency in young children. OFBs are complicated by significant morbidity and mortality because their ingestion often occurs without witnesses, leading to a delay in diagnosis and treatment. We report an occult OFB in an 11-month-old infant who initially presented without any specific respiratory symptoms, mimicking a respiratory infection. Worsening of the patient's cough, which did not show any improvement, despite treatment, and progressive onset of gastrointestinal manifestations (dysphagia, vomiting, and drooling) led to the diagnosis of an OFB (metallic spring). The complex and long-term clinical course of the patient highlights the need of promptly recognizing the presence of an occult OFB. This is because rapid diagnosis and treatment are essential for preventing severe and sometimes irreversible complications.
Topics: Cough; Delayed Diagnosis; Dilatation; Esophageal Stenosis; Esophagoscopy; Esophagus; Female; Foreign Bodies; Humans; Infant; Recurrence; Reoperation; Respiratory Sounds
PubMed: 29785865
DOI: 10.1177/0300060518767775 -
Revista Espanola de Enfermedades... Sep 2019Within the project "Quality indicators in digestive endoscopy", pioneered by the Spanish Society for Digestive Diseases (SEPD), the objective of this research is to... (Review)
Review
Within the project "Quality indicators in digestive endoscopy", pioneered by the Spanish Society for Digestive Diseases (SEPD), the objective of this research is to suggest the structure, process, and results procedures and indicators necessary to implement and assess quality in the gastroscopy setting. First, a chart was designed with the steps to be followed during a gastroscopy procedure. Secondly, a team of experts in care quality and/or endoscopy performed a qualitative review of the literature searching for quality indicators for endoscopic procedures, including gastroscopies. Finally, using a paired analysis approach, a selection of the literature obtained was undertaken. For gastroscopy, a total of nine process indicators were identified (one preprocedure, eight intraprocedure). Evidence quality was assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification scale.
Topics: Duodenoscopy; Endoscopy, Gastrointestinal; Esophagoscopy; Gastroscopy; Humans; Quality Improvement; Quality Indicators, Health Care
PubMed: 31190549
DOI: 10.17235/reed.2019.6023/2018 -
Gastroenterology May 2018Endoscopic techniques such as high-definition and optical-chromoendoscopy have had enormous impact on endoscopy practice. Since these techniques allow assessment of most... (Review)
Review
Endoscopic techniques such as high-definition and optical-chromoendoscopy have had enormous impact on endoscopy practice. Since these techniques allow assessment of most subtle morphological mucosal abnormalities, further improvements in endoscopic practice lay in increasing the detection efficacy of endoscopists. Several new developments could assist in this. First, web based training tools could improve the skills of the endoscopist for enhancing the detection and classification of lesions. Secondly, incorporation of computer aided detection will be the next step to raise endoscopic quality of the captured data. These systems will aid the endoscopist in interpreting the increasing amount of visual information in endoscopic images providing real-time objective second reading. In addition, developments in the field of molecular imaging open opportunities to add functional imaging data, visualizing biological parameters, of the gastrointestinal tract to white-light morphology imaging. For the successful implementation of abovementioned techniques, a true multi-disciplinary approach is of vital importance.
Topics: Barrett Esophagus; Diagnostic Imaging; Esophageal Mucosa; Esophagoscopy; Humans; Image Enhancement; Reproducibility of Results
PubMed: 29462601
DOI: 10.1053/j.gastro.2018.01.070 -
Cleveland Clinic Journal of Medicine Jun 2015
Topics: Eosinophilic Esophagitis; Eosinophils; Esophagoscopy; Esophagus; Humans
PubMed: 26086483
DOI: 10.3949/ccjm.82c.06002 -
World Journal of Gastroenterology Nov 2018Endoscopic cryotherapy is a relatively new thermal ablative modality used for the treatment of neoplastic lesions of the esophagus. It relies on cycles of rapid cooling... (Review)
Review
Endoscopic cryotherapy is a relatively new thermal ablative modality used for the treatment of neoplastic lesions of the esophagus. It relies on cycles of rapid cooling and thawing to induce tissue destruction with a cryogen (liquid nitrogen or carbon dioxide) leading to intra and extra-cellular damage. Surgical treatment was once considered the standard therapeutic intervention for neoplastic diseases of the esophagus and is associated with considerable rates of morbidity and mortality. Several trials that evaluated cryotherapy in Barrett's esophagus (BE) associated neoplasia showed reasonable efficacy rates and safety profile. Cryotherapy has also found applications in the treatment of esophageal cancer, both for curative and palliative intent. Cryotherapy has also shown promising results as salvage therapy in cases refractory to radiofrequency ablation treatment. Cryoballoon focal ablation using liquid nitrogen is a novel mode of cryogen delivery which has been used for the treatment of BE with dysplasia and squamous cell carcinoma. Most common side effects of cryotherapy reported in the literature include mild chest discomfort, esophageal strictures and bleeding. In conclusion, cryotherapy is an effective and safe method for the treatment of esophageal neoplastic processes, ranging from early stages of low grade dysplasia to esophageal cancer.
Topics: Barrett Esophagus; Cryosurgery; Esophageal Neoplasms; Esophagoscopy; Esophagus; Humans; Nitrogen; Palliative Care; Postoperative Complications; Precancerous Conditions; Salvage Therapy; Treatment Outcome
PubMed: 30487696
DOI: 10.3748/wjg.v24.i43.4862