Sunday, January 15, 2006

esophageal stricture

Esophageal stricture, or narrowing of the esophagus, is frequently encountered in the elderly. It is a serious manifestation not only because of the diseases that underlie it but also because of its implications as regards nutrition and aspiration.
Benign esophageal stricture is about one-third as common as carcinoma of the esophagus. The diagnoses of benign esophageal stricture should be made only after carcinoma has been completely excluded. Esophageal stricture usually occurs as a complication of reflux esophagitis, a penetrating peptic ulcer, a motor paralysis (usually due to stroke), or following the swallowing of a corrosive substance. A biopsy is essential to rule out malignancy.
The treatment for this condition is either the progressive dilation with bougies or the use of dilators, and correction of the cause if possible. The development of the esophageal balloon dilation catheters, used in conjunction with endoscopy to examine, will allow stretching of benign strictures under direct vision and in a controlled manner without surgery.
Brocklehurst, J. C. Textbook of Geriatric Medicine and Gerontology. New York: Churchhill Livingstone, 1985.


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