Hiatal hernia and peptic stricture: the most common complications after corrosive oesophageal stricture

ABSTRACT

To study the radiological appearances and possible complications in corrosive oesophageal stricture. 15 patients diagnosed as post corrosive upper GI injury are included in this study. Diagnostic studies were barium swallow examinations, either performed by the conventional method or by the recent digital method. The films of patients were studied for corrosive stricture sites, length and the presence of complications including hiatal hernia and peptic strictures. The patients had an age range of 4-50 years with a mean of 29.36 +/- 14.66 yrs. All patients were complaining of dysphagia. Heart burn was the complaint in 46.6% of patients, reflux was noted radiologically in 66% of cases. Short [less than 3 cm] and long strictures occurred with equal frequency, while annular stricture were uncommon. The most common site for stricture was the middle third of the thoracic oesophagus [60%]. Simultaneous gastric narrowing occurred in only 13.4% of cases. Complications of oesophageal strictures or its treatment by dilatation included FB impaction [6.7%], partial perforation [26.8%], malignancy [6.7%], hiatal hernia [93.3%] and peptic stricture [20%]. Hiatal hernia was the most common complication of corrosive oesophageal stricture and consequently peptic strictures were also common. In these patients reflux symptoms were masked by the dominant complaint of dysphagia due to the original stricture. In patients with corrosive oesophageal stricture treatment of GORD should be immediately initiated whenever hiatal hernia and reflux symptoms are observed. This strategy would diminish the possibility of peptic stricture, possibly dysplasia and carcinoma