Increased risk of esophageal perforation with dilation in patients with multiple esophageal webs (feline esophagus). A case control study

Shafi, MA; Eisen, GM; Al-Kawas, FH; Benjamin, SB

doi:10.1016/s0016-5107(97)80126-5

Cited by 5 publications

(4 citation statements)

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“…Esophageal dilation has been reported in 52% of patients (37–100%) in previous studies 2,3,12,14 . Perforation has been reported in only two patients after dilation and in one with simple passage of the endoscope 16,19 . One patient in our study reported a contained perforation after esophageal dilation at another institution.…”

Section: Discussionmentioning

confidence: 44%

“…2,3,12,14 Perforation has been reported in only two patients after dilation and in one with simple passage of the endoscope. 16,19 One patient in our study reported a contained perforation after esophageal dilation at another institution. All patients with esophageal perforations reported thus far have been managed conservatively.…”

Section: Esophageal Dilationmentioning

confidence: 85%

“…The findings from our retrospective case series, in combination with a thorough review of the medical literature, suggest that adult EE typically affects young adult men who have an allergic predisposition. 2,3,15,19 Nevertheless, given its occurrence in both men and women of various ages, EE should be considered in the differential diagnosis of chronic unexplained dysphagia, particularly with a history of recurrent esophageal food impaction. 2,8 The true prevalence is not known, most likely because the diagnosis is seldom considered by gastroenterologists and pathologists, and esophageal biopsy specimens are not routinely obtained.…”

Section: Discussionmentioning

confidence: 99%

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Patient characteristics, clinical, endoscopic, and histologic findings in adult eosinophilic esophagitis: a case series and systematic review of the medical literature

Pasha

DiBaise

Kim

et al. 2007

Diseases of the Esophagus

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The objective of our study is to describe patient characteristics, clinical, endoscopic, and pathologic features and management of adult eosinophilic esophagitis (EE). A retrospective review of adults with EE (20 or more eosinophils per high-power field) diagnosed between 1997 and 2006, and a systematic review of the medical literature was performed. Forty-two patients (31 male; 11 female) had EE. Mean (SD) age at diagnosis was 44 (15.8) years, with highest prevalence (48%) at age 20-39. Predominant symptoms were dysphagia (81%); median duration, 8 years; range, 1-30 years and food impaction (55%). Forty-three percent had allergy or atopy, 36% had asthma, 54% had peripheral eosinophilia, and 10% had a first-degree relative with dysphagia. Endoscopic findings included ringed esophagus (55%), linear furrows (33%), narrow esophagus (10%), normal esophagus (7%), and esophageal strictures (38%). Mean number of dilations was 2 (range, 1-5). There were no perforations, but superficial mucosal tears occurred in 31% of dilations. Nine patients were treated with topical fluticasone with clinical improvement in all four (100%) patients who were seen in follow-up. Pathologic findings included 20 or more eosinophils per high-power field from proximal or mid-esophageal biopsy specimens. A systematic review of 14 studies (11 manuscripts, 2 abstracts, and this case series) with 212 patients showed similar findings. EE should be suspected in young men with unexplained dysphagia or food impaction even in the absence of typical endoscopic findings of rings or corrugations, linear furrows, and narrow esophagus; diagnosis is confirmed by 20 or more eosinophils per high-power field on proximal or mid-esophageal biopsies; EE is associated with allergic or atopic disorders; topical steroids are effective in the management of EE; dilation of esophageal strictures is reasonably safe in EE.

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Section: Discussionmentioning

confidence: 44%

Section: Esophageal Dilationmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Patient characteristics, clinical, endoscopic, and histologic findings in adult eosinophilic esophagitis: a case series and systematic review of the medical literature

Pasha

DiBaise

Kim

et al. 2007

Diseases of the Esophagus

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“…Straumann et al (7) treated 11 EoE adult patients with dilation and reported complete improvement in 6 and partial relief in 4 without relevant complications. Shafi et al (18) treated 6 adult patients (16 endoscopic dilations), in which a significantly increased risk of esophageal perforation was observed (5 cases), especially among patients with “multiple esophageal webs.” Cohen et al (19) reported 10% of perforation after dilation but did not describe the stricture's diameter. In a recent report Eisenbach et al (20) also reported a case of esophageal perforation after dilation in a patient with EoE.…”

Section: Discussionmentioning

confidence: 99%

Severe Dysphagia in Children With Eosinophilic Esophagitis and Esophageal Stricture: An Indication for Balloon Dilation?

Robles-Medranda¹,

Villard²,

Gall³

et al. 2010

J. pediatr. gastroenterol. nutr.

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Vidéo-Digest 20e édition État de l’art en endoscopie digestive: « Les prothèses à tous les étages »

2009

Acta Endosc

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La désobstruction endoscopique palliative par endoprothèse duodénale ou gastroduodénale est un procédé sûr, modérément invasif, reproductible et rapidement efficace, utilisable chez la plupart des patients atteints de cancers obstructifs sténosant le duodénum ou la jonction gastroduodénale et récusés pour une exérèse curatrice.Les patients âgés et/ou avancés dans la maladie en sont les principaux bénéficiaires.Des récidives sont cependant observées dans 18 % des cas et peuvent être gérées endoscopiquement ; le procédé est donc moins définitif qu'une gastrojéjunostomie mais il semble plus adapté aux caractéristiques des patients considérés, dont le séjour hospitalier est raccourci ; il a en outre un meilleur rapport coût/efficacité. Le cancer pancréatique a vu son algorithme décisionnel significativement modifié par l'essor de cette méthode endoscopique : en garantissant une solution en cas de survenue tardive d'une sténose duodénale, elle conduit à renoncer à une chirurgie non curatrice carcinologiquement, pour dérivation au stade initial de l'ictère révéla-teur, et à préférer un drainage biliaire par endoprothèse cholédocienne.Une réflexion sur l'articulation optimale des stratégies endoscopiques de désobstruction biliaire et duodénale limite le risque d'impasse technique et d'échec chez ces sujets. Mots clésProthèse duodénale · Endoscopie · Prothèse biliaire · Cancer du pancréas · Gastrojéjunostomie · Anastomose gastrojéjunale

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Increased risk of esophageal perforation with dilation in patients with multiple esophageal webs (feline esophagus). A case control study

Cited by 5 publications

References 0 publications

Patient characteristics, clinical, endoscopic, and histologic findings in adult eosinophilic esophagitis: a case series and systematic review of the medical literature

Patient characteristics, clinical, endoscopic, and histologic findings in adult eosinophilic esophagitis: a case series and systematic review of the medical literature

Severe Dysphagia in Children With Eosinophilic Esophagitis and Esophageal Stricture: An Indication for Balloon Dilation?

Vidéo-Digest 20e édition État de l’art en endoscopie digestive: « Les prothèses à tous les étages »

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