Analysis of risk factors of radiation-induced toxicity in limited-stage small cell lung cancer treated with hypofractionated intensity-modulated radiotherapy / 中华肿瘤杂志

Objective: To compare the incidence of radiation-related toxicities between conventional and hypofractionated intensity-modulated radiation therapy (IMRT) for limited-stage small cell lung cancer (SCLC), and to explore the risk factors of hypofractionated radiotherapy-induced toxicities. Methods: Data were retrospectively collected from consecutive limited-stage SCLC patients treated with definitive concurrent chemoradiotherapy in Cancer Hospital of Chinese Academy of Medical Sciences from March 2016 to April 2022. The enrolled patients were divided into two groups according to radiation fractionated regimens. Common Terminology Criteria for Adverse Events (CTCAE, version 5.0) was used to evaluate the grade of radiation esophagus injuries and lung injuries. Logistic regression analyses were used to identify factors associated with radiation-related toxicities in the hypofractionated radiotherapy group. Results: Among 211 enrolled patients, 108 cases underwent conventional IMRT and 103 patients received hypofractionated IMRT. The cumulative incidences of acute esophagitis grade ≥2 [38.9% (42/108) vs 35.0% (36/103), P=0.895] and grade ≥ 3 [1.9% (2/108) vs 5.8% (6/103), P=0.132] were similar between conventional and hypofractionated IMRT group. Late esophagus injuries grade ≥2 occurred in one patient in either group. No differences in the cumulative incidence of acute pneumonitis grade ≥2[12.0% (13/108) vs 5.8% (6/103), P=0.172] and late lung injuries grade ≥2[5.6% (6/108) vs 10.7% (11/103), P=0.277] were observed. There was no grade ≥3 lung injuries occurred in either group. Using multiple regression analysis, mean esophageal dose ≥13 Gy (OR=3.33, 95% CI: 1.23-9.01, P=0.018) and the overlapping volume between planning target volume (PTV) and esophageal ≥8 cm(3)(OR=3.99, 95% CI: 1.24-12.79, P=0.020) were identified as the independent risk factors associated with acute esophagitis grade ≥2 in the hypofractionated radiotherapy group. Acute pneumonitis grade ≥2 was correlated with presence of chronic obstructive pulmonary disease (COPD, P=0.025). Late lung injuries grade ≥2 was correlated with tumor location(P=0.036). Conclusions: Hypofractionated IMRT are tolerated with manageable toxicities for limited-stage SCLC patients treated with IMRT. Mean esophageal dose and the overlapping volume between PTV and esophageal are independently predictive factors of acute esophagitis grade ≥2, and COPD and tumor location are valuable factors of lung injuries for limited-stage SCLC patients receiving hyofractionated radiotherapy. Prospective studies are needed to confirm these results.

Upper gastrointestinal endoscopy applied in pediatrics: endoscopic and histological findings, including Helicobacter pylori / Endoscopia digestiva alta aplicada em pediatria: hallazgos endoscópicos e histológicos incluyendo al Helicobacter pylory

Objective: To present and discuss the endoscopic and histological results, as well as the incidence of Helicobacter pylori and other diseases, indications and characteristics of upper digestive endoscopies performed in children. Material and methods: Twenty-five endoscopies were performed in children aged six months to 11 years (mean 7.69 years), from February 2013 to January 2016. In 200 patients, endoscopies were diagnostic and serial biopsies were performed (esophagus, stomach and duodenum), in 120 of them. Results: The indication of endoscopy was diagnosed in 88.89% of the patients, and in 26 patients, a therapeutic procedure was performed. The most frequent endoscopic findings were esophagitis in 49 patients, gastritis in 84 and duodenitis in 16 patients. Four duodenal ulcers were diagnosed. In the therapeutic endoscopies, six gastrostomies were performed, 14 foreign body withdrawals, five nasoenteral tube passages and esophageal dilatation. The H. pylori survey was performed by anatomopathological method and was positive in 26 (13%) of the 200 patients in whom it was searched. Conclusion: pediatric endoscopy is an important niche of the digestive endoscopy, where it is important to emphasize the relevance of the institutional structure that performs these procedures, in order to conduct them safely, being able to treat possible and feasible complications

Objetivo: Presentar y discutir los hallazgos endoscópicos e histológicos, así como la incidencia de Helicobacter pylori y otras enfermedades, indicaciones y características de endoscopia digestiva alta realizada en niños. Material y métodos: Fueron realizadas 225 endoscopias en niños de seis meses a 11 años (media de 7,69 años) a partir de febrero de 2013 hasta enero de 2016. En 200 pacientes, en las endoscopias diagnósticas se llevan a cabo biopsias seriadas (esófago, estómago y duodeno) en 120 de ellos. Resultados: La indicación de endoscopia fue diagnóstica en el 88,89% de los pacientes y en 26 pacientes se realizaron un procedimiento terapéutico. Los hallazgos endoscópicos más frecuentes fueron esofagitis en 49 pacientes, gastritis y duodenitis 84 y en 16 pacientes se diagnosticaron cuatro úlceras duodenales. En endoscopias terapéuticas fueron realizadas seis gastrostomías, catorce extracciones de cuerpos extraños, cinco pasajes de sonda nasogástrica y una dilatación esofágica. El estudio de H. pylori se realizó por el método histopatológico y fué positivo en 26 (13%) de 200 pacientes en los que se han buscado. Conclusión: La endoscopía pediátrica es un nicho importante de la endoscopía digestiva donde es importante enfatizar la relevancia de la estructura institucional que realiza estos procedimientos para conducirlos con seguridad y ser capaces de tratar las complicaciones posibles

Prevalence and Risk Factor of Erosive Esophagitis Observed in Korean National Cancer Screening Program

Prevalence of erosive esophagitis (EE) has been increasing in Korea. The purpose of this study was to estimate prevalence of EE among low socioeconomic population in Korea and to investigate risk factors for EE. We reviewed the medical records of 7,278 subjects who were examined by upper endoscopy in the Korean National Cancer Screening Program at Chung-Ang University Yong-san Hospital from March 2003 to March 2008. The study population included subjects > or = 40 yr of age who were Medicaid recipients and beneficiaries in the National Health Insurance Corporation. Multivariate analysis was used to determine risk factors for EE. Prevalence of EE was 6.7% (486/7,278). According to the LA classification system, LA-A in 344 subjects, LA-B in 135 subjects, and LA-C and D in 7 subjects. In multivariate analysis, age > or = 60 yr, male sex, BMI > or = 25, current smoking, alcohol consumption, fasting glucose level > or = 126 mg/dL, and endoscopic hiatal hernia were significant risk factors for EE. The prevalence of EE in low socioeconomic Korean population is similar to that in personal annual medical check-ups. Risk factors for EE among them include old age, male sex, BMI > or = 25, current smoking, alcohol consumption, fasting glucose level > or = 126 mg/dL, and hiatal hernia.

Prevalência de alterações laríngeas em portadores de esofagite erosiva / Prevalence of laryngeal alterations in patients with erosive esophagitis

Introdução: A associação entre Doença do Refluxo Gastroesofágico (DRGE) e alterações laríngeas vem sendo muito debatida nos últimos anos. Estudos recentes sugerem associação entre sintomas laríngeos, sintomas faríngeos e refluxo extra-esofágico, como sendo apresentação atípica da Doença do Refluxo Gastroesofágico. Objetivo: Correlacionar a presença de alterações laríngeas com os graus de esofagite erosiva. Método: Estudo prospectivo. Os pacientes com achados de esofagite a endoscopia foram classificados de acordo com Los Angeles e submetidos a um questionário seguido de laringoscopia. O teste do qui-quadrado foi utilizado para análise estatística (p<0,05). Resultados: Os pacientes com sintomas típicos de refluxo gastroesofágico corresponderam a 96,6%. Dezoito possuíam alterações compatíveis com classe A(60%), 7 com classe B (7%) e 5 com classes C + D (16,6%). A presença de alterações laringoscópicas foi mais prevalente nas esofagites mais severas (classes C e D de Los Angeles) quando comparada aos graus mais leves (classes A e B), diferença estatisticamente significativa (p<0,05). Conclusão: As alterações laríngeas são achados frequentes nos pacientes com esofagite, sendo mais prevalentes quanto maior o grau da lesão esofágica.

Introduction: The association between gastroesophageal reflux disease (GERD) and laryngeal disorders has been much debated in recent years. Recent studies suggest an association between laryngeal symptoms and pharyngeal symptoms extra-esophageal reflux, as atypical presentation of Gastroesophageal Reflux Disease. Objectives: To correlate the presence of laryngeal to the grades of erosive esophagitis. Methods: A prospective study. Patients with findings of esophagitis on endoscopy were categorized according to LosAngeles and submitted a questionnaire followed by laryngoscopy. The chi-square test was used for statistical analysis (p<0.05). Results: Patients with typical symptoms of gastroesophageal reflux disease accounted for 96.6%. Eighteen had changes consistent with class A (60%), class B with seven (7%) and 5 with classes C + D (16.6%). The presence of laryngeal changes were more prevalent in more severe esophagitis (grades C and D Los Angeles) when compared to milder forms (classes A and B), a statistically significant difference (p<0.05). Conclusion: The laryngeal disorders are frequent findings in patients with esophagitis, more frequent the greater the degree of esophageal injury.

Clinical Significance of Incidentally Detected Eosinophilic Esophagitis with Pathologic Review / 대한소화기학회지

BACKGROUND/AIMS: Eosinophilic esophagitis (EE) is a chronic inflammatory disorder characterized by abnormal dense eosinophilic infiltration of esophageal mucosa and results in dysphasia and food impaction. EE is being increasingly recognized in adults. The prevalence is largely unknown. This study was performed to evaluate the detection rate of EE diagnosed based on pathologic criteria and to define the clinical characteristics of EE in Korea. METHODS: We reviewed biopsy specimen of the 1,609 patients who underwent esophageal biopsy from January 2006 till August 2008. The presence of more than 20 eosinophils per high power field in biopsy specimens was considered cases of EE. Clinical information and endoscopic findings were obtained. RESULTS: 7 (0.4%) patients were diagnosed as EE based on pathologic criteria retrospectively. Clinical symptoms were epigastric pain (43%), regurgitation (29%), dyspepsia (14%), and no symptom (14%). Endoscopic findings were whitish exudates or granules (57%), esophageal polyp (29%), and hyperemic change (14%). Two patients received treatment. One patient with bronchial asthma improved after treatment with inhaled corticosteroid, and one patient improved after 8 week proton pump inhibitor therapy. CONCLUSIONS: Eosinophilic esophagitis was found in 0.4% of the total esophageal biopsied cases. Our results suggest that Korean patients with eosinophilic esophagitis showed symptoms mimicking gastroesophageal reflux disease and atypical endoscopic findings. Therefore, regardless of the gross appearance of the mucosa, meticulous diagnostic approaches are needed for patients with swallowing difficulty and lack of response to proton pump inhibitor.

Esofagitis eosinofílica: una entidad emergente / Eosinophilic Esophagitis: an emerging entity

La esofagitis eosinofílica (EE) es una enfermedad primaria del esófago, previamente confundida con el reflujo gastroesofágico (RGE), cuyo conocimiento se ha desarrollado principalmente en la última década. Se define como la presencia de síntomas de disfunción esofágica (principalmente disfagia e impactación alimentaria), asociados a por lo menos una biopsia esofágica con más de 15 eosinófilos por campo de mayor aumento (CMA), y la exclusión de RGE. Su prevalencia va en aumento y afecta principalmente a niños y hombres jóvenes de raza blanca con historia previa de atopía. La EE sería causada por una reacción alérgica a ciertos alimentos y/o aeroalérgenos mediada por citoquinas y con cambios genéticos involucrados. La presentación clínica varía con la edad siendo la disfagia el síntoma más frecuente en todos los grupos etarios. El diagnóstico es clínico, endoscópico y anatomopatológico. Se requiere de una endoscopía digestiva alta (EDA) para evaluar hallazgos característicos y tomar biopsias para el estudio histológico. Los tratamientos actuales incluyen medidas dietéticas basadas en la eliminación de la exposición de alérgenos alimentarios y uso de corticoesteroides tópicos. El objetivo de esta revisión es analizar el estado actual de la definición de EE, historia, epidemiología, fisiopatología, diagnóstico y principalmente ayudara mejorar su sospecha diagnóstica y manejo.

Eosinophilic esophagitis (EE) is a primary disease of the esophagus, previously mistaken with gastroesophageal reflux disease (GERD). Its knowledge has developed over the last decade. EE is defined as the presence ofesophageal dysfunction symptoms (mostly dysphagia and food impaction) associated to at least 1 esophageal biopsy with 15 or more eosinophils in 1 high-power field and absence of GERD. Its prevalence is rising, affecting principally white boys and young males with previous history of atopy. EE would be caused by an allergic reaction to certain food and aeroallergens mediated by citoquines with genetic changes involved. Clinical presentation varies with age being dysphagia the most common symptom in all age goups. The diagnosis is clinical, endoscopic and histopathologic. It requires an endoscopy to evaluate mucosal findings and to take the biopsies. Treatment includes elimination diets and topical steroids. The purpose of this review is to analyze the current state of the definition, history, epidemiology, fisiopathology and the diagnosis of EE, with an emphasis on improving its suspicion index and initial management.

Candida esophagitis: species distribution and risk factors for infection / Esofagite por Candida: distribuição da espécie e fatores de risco para a infecção

Although Candida albicans is the main cause of fungal esophagitis, other species such as C. tropicalis, C. krusei and C. stellatoidea have also been implicated. Several studies have identified risk factors for C. albicans esophagitis. However, data for non-C. albicans species is still sparse. The aim of this study was to determine the etiology of Candida esophagitis in our medical centre over an 18-month period. Additionally, we aimed to investigate predisposing conditions for esophageal candidosis caused by different Candida species. A total of 21,248 upper gastroscopies were performed in Santa Casa Complexo Hospitalar between January 2005 and July 2006. The prevalence of Candida esophagitis was 0.74 percent (n = 158). C. albicans caused the vast majority of infections (96.2 percent), followed by C. tropicalis (2.5 percent), C. lusitaniae (0.6 percent) and C. glabrata (0.6 percent). There were 81 women (51.3 percent) and 77 men (48.7 percent). No case of mixed infection occurred. Concomitant oral candidosis was documented for 10.8 percent (n = 17). Most of cases (55.1 percent) involved outpatients. Around one fifth of patients in our cohort had no identifiable risk factors for esophageal candidosis (20.8 percent). Since nearly all infections were caused by C. albicans we were not able to determine risk factors for esophagitis caused by other Candida species.

Embora Candida albicans seja a principal causa de esofagite fúngica, outras espécies como C. tropicalis, C. krusei e C. stellatoidea também têm sido implicadas. O objetivo desse estudo foi descrever espécies causadoras de esofagite fúngica em nosso centro durante um período de 18 meses, além de comparar condições predisponentes para candidose esofágica causadas por diferentes espécies de Candida. De janeiro de 2005 a julho de 2006, 21.248 endoscopias digestivas altas foram realizadas no Complexo Hospitalar Santa Casa (Porto Alegre, Brasil). A prevalência de esofagite por Candida foi de 0,74 por cento (n = 158). C. albicans foi a causadora da maioria das infecções (96,2 por cento), seguida por C. tropicalis (2,5 por cento), C. lusitaniae (0,6 por cento) e C. glabrata (0,6 por cento). Candidose oral concomitante foi documentada em 10,8 por cento (n = 17). Cerca de 21 por cento dos pacientes não teve qualquer fator de risco identificável para candidose esofágica. Em função do pequeno número de pacientes infectados por espécies não-Candida albicans, não foi possível determinarmos fatores de risco para estas infecções.

Estudio de test de ureasa en exámenes endoscópicos con patologías benignas: ¿algún cambio en diez años? / Positivity of urease tests: results of its application in an open-access unity after a decade is there any change?

Epidemiological studies have shown changes in upper digestive diagnosis in recent times. It has been observed especially in developed countries, consisting in a diminution of duodenal peptic ulcers and non cardial gastric cancer and an increase of symptoms and lesions attributable to gastroesophageal reflux. Both circumstances have been considered as a consequence of a reduction in the prevalence, of infection with Helicobacter pylori and its more aggressive strains. There is little information of Possible changes in our country, so we have studied our experience in years 1996 and 2006 observing the results of Helicohacter pylori presence through urease tests and biopsies in a 10 year period. Patients were assessed with endoscopy indicated for upper digestive symptoms in an open access University Endoscopy Center. The accuracy of the test compared with biopsies was similar in both years. We observed after a decade: increase in the number of examinations and urease tests similar percentages of normal endoscopies and those with esophagitis, gastritis, or ulcers. In patients studied for suspected gastroesophageal reflux, there were similar percentages of those with and without esophageal erosions. The Urease Test was positive in similar high percentage in duodenal ulcers, but showed decreased values in patients studied for reflux, both erosive and non erosive esophagitis and also in erosive gastritis. In conclusion, Helicobacter pylori infection is still important in duodenal ulcer, with reductions in other diagnosis, possibly as a consequence of differences in patients social status or the very common medication aiming at the eradication of the infection or control of gastroesophageal symptoms.

Estudios epidemiológicos han mostrado cambios en la incidencia de patologías digestivas consistentes en disminución de úlceras duodenales y cáncer gástrico y aumento de cuadros atribuidos a reflujo gastroesofágico. Ambas tendencias se han asociado a disminución de la tan difundida infección por Helicobacter pylori y sus cepas genéticamente más agresivas. El presente estudio tuvo come objeto revisar retrospectivamente los resultados de endoscopias en 1996 y 2006 para observar eventuales cambios en la patología de esófago y gastroduodenal. Los resultados en la última década indican: aumento del número de exámenes y de tests de ureasa; proporción similar, de: endoscopias normales, esofagitis erosiva, síntomas de reflujo no erosivo, gastritis erosiva, úlcera gástrica, úlcera duodenal; porcentaje similar de esofagitis erosiva y reflujo no erosivo en pacientes estudiados por síntomas sugerentes de reflujo gastroesofágico y disminución de la positividad del TU, significativamente en EE y GE. Pensamos que el Hp continúa siendo factor patogénico en UD y que la disminución de positividad en pacientes con RGE puede atribuirse a cambios en la composición de la población examinada y al uso de medicación que puede modificar su presencia en la mucosa de estómago, siendo similar la reducción en reflujo con y sin esofagitis erosiva.

Endoscopic and histologic findings in Iranian patients with heartburn.

BACKGROUND: Heartburn is a common manifestation of gastroesophageal reflux disease. Barrett's esophagus and esophageal adenocarcinoma, known complications of this disease, appear to be less prevalent in Asia than in Western countries. We looked for endoscopic and histologic evidence of Barrett's esophagus in Iranian patients with heartburn. METHODS: During September 2001 to September 2003, endoscopy was done in all patients with heartburn, either lasting longer than 3 months (n=1182) or for 1-3 months but resistant to 4 weeks of omeprazole therapy (n=66). Biopsy was taken from columnar-lined mucosa above the GE junction, at 5 cm above the Z line in normal- appearing mucosa, and from any abnormal areas. RESULTS: Of the 1248 patients (mean age 45 [SD 15.5] years, 750 men; duration of heartburn 68 [SD 87.5] months), 960 (66.5%) had erosive esophagitis and 30 (2.4%) had Barrett's esophagus, including 10 and 20 with long- and short-segment involvement, respectively. Of 134 patients with normal-appearing mucosa, 122 had histologic evidence of esophagitis. CONCLUSION: Barrett's esophagus may be less common in Iran than in Western countries, despite presence of severe heartburn and erosive esophagitis.

Gastrointestinal lesions and helicobacter pylori in patients with myeloproliferative disorders

The aim of this study is to investigate the endoscopic lesions, and Helicobacter pylori [H. pylori] positivity in patients with myeloproliferative disorders [MPD]. Thirty patients with MPD and 93 controls with functional dyspepsia were enrolled in this study after informed consent obtained between March 2000 and July 2003. The study was held at the Departments of Hematology and Gastroenterology, Adnan Menderes University Faculty of Medicine, Adnan, Turkey. Physical examination, hemogram, peripheral blood examination, upper endoscopic examinations were performed in all patients. Helicobacter pylori positivity was evaluated by rapid urease test, and by histopathological examination of the biopsies obtained from antrum and corpus. The H. pylori positivity was 46.7% in MPD and 19.4% in control group [p<0.05]. The prevalence of gastritis was much higher in MPD patients than control group [p<0.05]. There was no gastrointestinal bleeding in control group but 8 patients in MPD group [26.7%; p<0.05]. The higher susceptibility of H. pylori infection and high frequency of gastric lesions in patients with MPD suggests a surveillance of these patients. The eradication of H. pylori to avoid probable gastrointestinal problems is advised in MPD patients

role of helicobacter pylori in esophagitis and peptic ulcer disease in Iraq

The objectives of this study are to determine the prevalences of Helicobacter pylori [H.pylori] infection in symptomatic, but endoscopically normal patients as well as in patients with endoscopically and histologically proven esophagitis, gastritis, duodenitis, duodenal ulcer, and gastric ulcer. The study extended over the period November 1999 through June 2000. Biopsy specimens were harvested from intact areas of gastric antral mucosa, duodenal bulb, gastric body and lower third of esophagus of each one of 200 patients undergoing eseophago-gastro-duodenoscopy in endoscopy unit of Tikrit General Hospital [TGH], Salahuddin Governorate, Tikrit City, Iraq. The biopsies were submitted for histopathological, cultural and biochemical investigations. Seven biopsy samples were taken from each patient. Written consent was taken from each patient. The patients were pooled from various districts of the governorate. Results:Helicobacter pylori was detected in antral biopsies of the following categories of patients: in 73.9% of patients with endoscopic gastritis, in 75% of patients with gastric ulcers, in 86% of patients with endoscopic duodenitis, in 88.6% of patients with duodenal ulcers and in 57.7% of patients with endoscopic esophagitis, but absent in all patients with totally normal endoscopies. Although H.pylori has no role in the development of esophagitis, it is a prevalent pathogen and is associated with many gastro-intestinal diseases and has an important role in the pathogenesis of peptic ulcer disease and gastritis in our district

Upper gastrointestinal endoscopy findings at Riyadh Armed Forces Hospital

To analyze the results of upper gastrointestinal endoscopic findings performed at Riyadh Armed Forces Hospital over a period of 15 years in 18,829 patients who were entered in the computer at the endoscopy unit. A retrospective study based on data of 18,829 patients who underwent upper gastrointestinal endoscopy. The data was entered into a computer with special codes for symptoms and endoscopic findings. Eighteen thousand eight hundred and twenty nine upper gastrointestinal endoscopy results were analyzed. Oesophagitis was found in 16.45%, Hiatus Hernia in 10%, Oesophageal varices in 7%, Oesophageal Cancer in 1.14%, Gastritis in 22%, Gastric erosions in 13.6%, Benign gastric ulcer in 3.29%, Gastric malignancy in 1.22%, Duodenal Ulcer in 14%, Duodenal erosions in 3.7% and Duodenitis in 12.7%. Only in 5.15% endoscopic findings were normal. In our analysis only 5.15% had normal upper gastrointestinal endoscopy findings while majority of patients had abnormal findings

Etude des oesophagites a Bamako : a propos de 228 cas

Les auteurs de cet article ont eu comme principal objectif d'etudier la prevalence des oesophagites au moyen de l'endoscopie digestive haute. En 12 mois ils ont collige 228 cas d'oesophagite dans 63;59 pour cent des cas chez l'homme adulte jeune. L'oesophagite peptique a ete plus frequente et ses aspects congestifs ont ete plus courants. La principale indication de l'endoscopie chez les malades atteints d'oesophagite a ete les epigastralgies

Enfermedad por reflujo gastroesofágico patológico: controversia actual / Pathological gastroesophageal reflux disease: present controversy

El reflujo gastroesofágico (RGE) adquiere significación patológica cuando se hace frecuente, periódico, nocturno y cuando el pH esofágico es anormal en más del 5 por ciento del tiempo en 24 h. En estudio esdoscópico personal en 2,589 endoscopías se encontró esofagitis en un 6 por ciento , siendo ésta severa en un 2 por ciento . Los factores fisiopatológicos involucrados son múltiples. Los elementos básicos para su diagnóstico son la clínica, endoscopías y monitoreo de pH en 24 h. El tratamiento médico es efectivo en la mayoría de los casos, pero presenta alta recurrencia. La cirugía se indica en los casos con RGE severo, alcalino, en complicaciones y disfunción motora asociada. Las alternativas quirúrgicas más empleadas son la técnica de Nissen y Hill Larraín asociadas a vagotomía supraselectiva. La operación de derivación exclusión (antrectomía más gastroyeyunoanastomosis en Y de Roux) asociados a cirugía antirreflujo se indica en la esofagitis severa, RGE patológico recidivado, RGE alcalino, cirugía gástrica concomitante, asociación con esclerodermia o acalasia

Hallazgos endoscopicos de esofagitis en pacientes con sintomas de reflujo gastroesofagico / Endoscopic esophagitis findings in patients with gastroesophageal reflux symptoms

Entre Enero de 1984 y Diciembrre de 1986 en un grupo de pacientes con síntomas de reflujo gastroesofágico se estudiaron los hallazgos endoscópicos de los diferentes grados de esofagitis de acuerdo a la clasificación europea. Se encontró un 5% de pacientes con signos endoscópicos de esofagitis, siendo los mas frecuentes el Grado I (leve) o bien el hallazgo de esófago de Barrett. Sus síntomas fueron similares a lo reportado en la literatura y la distribución de edad y sexo en cada grupo de diverso grado de esofagitis no fueron significativamente diferentes. El cambio de mucosas escamosas o columnar se encontró significativamente más alto en pacientes con esofagitis Grado III y IV