Oesophagus stricture

More alkaline reflux in the oesophagus of Barrett s patients or patients with oesophagitis or stricture, compared to controls (uncomplicated GORD, volunteers or no GORD)... 

Lundell L (1992) Acid suppression in the long-term treatment of peptic stricture and Barrett s oesophagus. Digestion 51 (Suppl 1) 49-58... 

This is mainly a classification of active disease and does not take complications of gastro-oesophageal reflux disease into account, i.e. scar formation and strictures. In dysphagic patients with no other symptom or sign of reflux oesophagitis, carcinoma of the oesophagus must be excluded. 

A full anatomic description includes the distal part of the stricture, which may not be correctly delineated if the oesophagus distal to it is not fully distended with air. In such cases the length of the stricture is easily exaggerated. 

Adenocarcinomas arising from Barrett s metaplasia may start as polypoid masses and then grow into infiltrative and stricturing lesions. Sometimes tiny satellite tumours are seen adjacent to the main tumour. Biopsies from the oesophagus inferior to the tumour may establish its metaplastic origin. 

Organic lesions of the oesophagus may cause impaction of food and foreign bodies. Such lesions are ring formations, strictures, and intraluminal tumours. Defective muscular function, as in achalasia, may also cause impaction. 

Fig. 3.18a-c. Malignant stricture of the mid-oesophagus with irregular margins (a). Dilatation with a hydraulic balloon (b), and permanently treated with an expandable metal stent to keep the lumen patent (c)... 

Submucosal lesions in the oesophagus are also encountered, a relatively rare one being intramural pseudodiverticulosis (Flora et al. 1997) (Fig. 4.26). This is a condition of unknown aetiology, but which has an association with diabetes, alcohol abuse, reflux disease, and oesophageal strictures. It is more commonly seen in patients with oesophageal carcinomas than in matched controls, and there... 

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