An audit of endoscopic complications in adult eosinophilic esophagitis.
Clin Gastroenterol Hepatol
; 5(10): 1149-53, 2007 Oct.
Article
em En
| MEDLINE
| ID: mdl-17683993
ABSTRACT
BACKGROUND & AIMS:
Eosinophilic esophagitis (EoE) in adults, characterized by the triad of dysphagia, a ringed esophagus, and mucosal eosinophilic infiltration, has associated complications that include vertical mucosal lacerations, instrumental perforation, and emesis-induced rupture. The aim of this study was to determine whether clinical, endoscopic, and histologic features can be used to predict the risk for development of these complications.METHODS:
A review was conducted of 36 patients with EoE. Complications were defined as mucosal lacerations or radiographic evidence of perforation.RESULTS:
The mean age at presentation was 33.9 years. Twenty-eight (78%) patients were men. Complications occurred in 11 patients (31%). There were 7 mucosal lacerations, 3 perforations, and 1 emesis-induced rupture. Strictures were reported in 7 of 11 complicated cases compared with 2 of 25 of uncomplicated cases. Dilatation procedures had been performed in 6 of 7 complicated cases associated with stricture. Biopsy specimens obtained from 7 of 9 patients with complications showed 40 or more eosinophils/high-power field. There were no statistical differences between complicated and uncomplicated patients regarding demographics, clinical features, endoscopic characteristics, or histopathologic findings.CONCLUSIONS:
EoE is a high-risk disorder with a range of complications. Although demographics, clinical presentation, and endoscopic features cannot distinguish risk, the presence of stricture, a longer duration of symptoms, and a greater density of eosinophilic infiltration suggest increased risk. The density of eosinophilic infiltration cannot be determined prospectively; therefore, the performance of endoscopy and subsequent dilatation should be deferred until biopsy specimens are reviewed or treatment is completed.
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Base de dados:
MEDLINE
Assunto principal:
Vômito
/
Endoscopia Gastrointestinal
/
Eosinofilia
/
Esofagite
/
Esôfago
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Clin Gastroenterol Hepatol
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2007
Tipo de documento:
Article
País de afiliação:
Estados Unidos