ABSTRACT
Las estenosis esofágicas son situaciones relativamente frecuentes en la práctica médica diaria. Se dividen en malignas y benignas de acuerdo con significación, pronóstico y conducta ante ellas. Mientras que en el primer grupo predominan las neoplasias primarias de esófago, el segundo representa un grupo de causas múltiples y heterogéneas. El presente trabajo trata sobre el desarrollo de una estenosis esofágica benigna, de tipo isquémico, a partir del uso de sonda de balón (sonda de Blakemore-Sengstaken) para tratar un episodio de sangrado digestivo alto. Debido a lo infrecuente de esta complicación, así como a la escasez de datos científicos o investigativos sobre el tema, se discuten los posibles mecanismos fisiopatológicos involucrados, así como las principales estrategias terapéuticas, tanto profilácticas como curativas, necesarias para la atención de estos pacientes
Subject(s)
Esophageal Stenosis/physiopathology , Esophageal Stenosis/therapy , Prospecting ProbeABSTRACT
The objective of the present study was to assess esophageal motor function in 21 children (7.5 ± 2.9 years) with caustic strictures. Esophageal manometry was performed using a water-infusion system interfaced with a polygraph and displayed on a computer screen. The data were compared with those obtained from 9 healthy children. Radionuclide transit was determined by studying deglutition of a single bolus of 99mTc pertechnetate in 10 ml of water. Non-peristaltic low-amplitude and long-duration waves were the most common findings detected in patients with strictures longer than 20 percent of esophageal length (N = 11). Compared with the control group, these patients presented lower mean amplitude and longer mean duration of waves (24.4 ± 11.2 vs 97.9 ± 23.7 mmHg, P < 0.05, and 6.7 ± 2.4 vs 1.6 ± 0.1 s, P < 0.05, respectively). Six patients presented low-amplitude waves just below the constricted site. Ten children presented delayed esophageal transit. There was an association between dysphagia and abnormalities on manometry (P = 0.02) and between symptoms and scintigraphy data (P = 0.01). Dysphagia in caustic strictures is due to esophageal motility abnormalities, which are closely related to the scarred segment.