[Update in the endoscopic management of benign esophageal stenoses]. 2005

Salvador Javier De la Garza González, and Rafael Guevara García
Departamento de Gastroenterología, Centro Médico del Hospital San José, Monterrey, N.L. drsalvadordelagarza@prodigy.net.mx

Correction of dysphagia in benign esophageal stenosis without the need for surgery is a task that has been tried to be resolved for more than three centuries; in the last three decades this management has evolved with the development of pneumatic dilators and, more recently, alternative and adjuvant treatments like local steroid injection, electrocoagulation, use of argon plasma and the use of expandable stents have been added. The most common causes of benign esophageal stenosis are peptic esophagitis in first place followed by the ingestion of caustic substances; other less frequent etiologies are medication ingestion, stenosis secondary to a surgical anastomosis of the esophagus and stenosis related to mediastinal radiotherapy; the rarest causes include esophageal rings and membranes, sclerotherapy for esophageal varices, the prolonged use of a nasogastric tube, Crohn's disease, among others. A complete clinical, radiological and endoscopic evaluation of the patient is required to make the diagnosis, with the respective complimentary histopathologic study. At present, traditional esophageal dilatations, as well as pneumatic dilatations are the most common and effective treatments, the previously mentioned alternative and adjuvant treatments are used in exceptional cases, some with advantages over the others depending on each patient in particular and on the characteristics and etiology of the stenosis. The future seems to be aimed at the use of temporary expandable stents.

UI MeSH Term Description Entries
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D002057 Burns, Chemical Burns caused by contact with or exposure to CAUSTICS or strong ACIDS. Chemical Burns,Burn, Chemical,Chemical Burn
D002404 Catheterization Use or insertion of a tubular device into a duct, blood vessel, hollow organ, or body cavity for injecting or withdrawing fluids for diagnostic or therapeutic purposes. It differs from INTUBATION in that the tube here is used to restore or maintain patency in obstructions. Cannulation,Cannulations,Catheterizations
D002986 Clinical Trials as Topic Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries. Clinical Trial as Topic
D004106 Dilatation The act of dilating. Dilation,Dilatations,Dilations
D004564 Electrocoagulation Procedures using an electrically heated wire or scalpel to treat hemorrhage (e.g., bleeding ulcers) and to ablate tumors, mucosal lesions, and refractory arrhythmias. It is different from ELECTROSURGERY which is used more for cutting tissue than destroying and in which the patient is part of the electric circuit. Diathermy, Surgical,Electrocautery,Endocavitary Fulguration,Galvanocautery,Surgical Diathermy,Thermocoagulation,Fulguration, Endocavitary
D004940 Esophageal Stenosis A stricture of the ESOPHAGUS. Most are acquired but can be congenital. Esophageal Stricture,Stenosis, Esophageal,Esophageal Stenoses,Stricture, Esophageal
D004942 Esophagitis, Peptic INFLAMMATION of the ESOPHAGUS that is caused by the reflux of GASTRIC JUICE with contents of the STOMACH and DUODENUM. Esophagitis, Reflux,Esophagitides, Peptic,Esophagitides, Reflux,Peptic Esophagitides,Peptic Esophagitis,Reflux Esophagitides,Reflux Esophagitis
D004945 Esophagoscopy Endoscopic examination, therapy or surgery of the esophagus. Esophagoscopic Surgical Procedures,Surgical Procedures, Esophagoscopic,Esophagoscopic Surgery,Surgery, Esophagoscopic,Esophagoscopic Surgeries,Esophagoscopic Surgical Procedure,Esophagoscopies,Procedure, Esophagoscopic Surgical,Procedures, Esophagoscopic Surgical,Surgeries, Esophagoscopic,Surgical Procedure, Esophagoscopic
D005471 Fluoroscopy Production of an image when x-rays strike a fluorescent screen. Fluoroscopies

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