HighlightsThe risk for esophageal cancer increases after ingestion of caustic substances.Management of patients with corrosive injuries remains controversial.Surgical approach does not seem to eliminate the risk for cancer, as confirmed in our case.The need for long-term follow up in these patients has to be underscored.

The associations between symptoms and endoscopic findings have not been clearly defined. We aimed to assess the associations of reflux dyspepsia and/or symptoms with specific endoscopic findings, histological findings, as well as the presence of Helicobacter pylori infection and its CagA subtype. A total of 160 patients with dyspeptic and/or reflux symptoms underwent upper gastrointestinal endoscopy. Type and severity of symptoms during the last week were evaluated according to a questionnaire. Biopsy specimens were obtained from the esophagus and stomach. Presence of H. pylori was tested in tissue specimens and its CagA subtype in serum samples. Of the 160 patients, 70% reported reflux, 73.7% dyspeptic symptoms, while 43.7% of patients reported both. The major endoscopic findings were chronic gastritis (n = 134), hiatal hernia (n = 98), and erosive esophagitis (n = 55). There was no significant difference in the endoscopic findings of patients with and without dyspepsia except for the subgroup of ulcer-like dyspeptic patients with significantly more frequently erosive peptic lesions (25% vs. 8.7%, p = .01). Patients with reflux symptoms had more frequently erosive esophagitis (42.9% vs. 14.6%, p = .001). Types of histological lesions, presence of H. pylori infection, and its cagA subtype had no statistical difference with presence or not of any symptoms. Patients with compared with those without reflux or ulcer-like dyspeptic symptoms had endoscopically more frequently erosive esophagitis and erosive peptic lesions, respectively. On the contrary, there is no statistical difference regarding the histological lesions, the presence of H. pylori, and its cagA subtype in all subgroups of patients.

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Background: Surgery is the most efficient treatment to achalasia of the esophagus with a success rate estimated 90%. Laparoscopic myotomy is combined with a fundoplication. One of the most common types of wrap is the anterior partial fundoplication, also known as Dor fundoplication. The 10% of surgical failure has been attributed to incomplete myotomy and/or tight fundoplication. The present study describes a modified anterior partial fundoplication that may have the potential to improve the clinical outcome of surgical treatment for achalasia.Methods: In this prospective study, we describe a modification of the standardized technique of Dor fundoplication applied to twenty-nine achalasia patients with intention to decrease the rates of failure. Short-term clinical result was evaluated with preoperative and six- months postoperative Eckardt scores (ES).Results: The mean number of months from initial symptoms to the time of diagnosis was 35.5 months (range 3-156 months). According to the Chicago Classification (CC v3.0), 11 patients (37.9%) were classified as achalasia type I, 17 (58.6%) as type II and 1 (3.4%) as type III. The mean ES was diminished from 7.8 to 0.6 postoperatively.Conclusions: The modification proposed in the present study omits the fixation of the right side of the myotomy to the right crus. This alteration may have the potential to anatomically and functionally affect postoperative rates of dysphagia and antireflux result among patients surgically treated for achalasia.

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