Endoscopic evalution of acute dysphagia due to mechanical obstruction

ABSTRACT

To find out the common causes of mechanical dysphagia in South Punjab and determine the endoscopic features of benign and malignant stricture to decide for either therapeutic intervention [endoscopic dilatation/stunting] or biopsy. This descriptive study was conducted in Medical Unit-1, Gastroenterlogy Nishtar Hospital Multan Pakistan during the period from September 2004 to December 2005. A total 50 patients were included in the study. Foreign body in esophagus, was seen in 3 patients [6%] 2 female and one male. Two patients [4%] had esophageal web, both patients were female and upper part of oesophagus was involved in both of them. Benign stricture was the commonest abnormality. Lower third of oesophagus was the commonest site of involvement [62.5%], middle one third was involved in 31.25% of cases while upper third was involved in only 1 patient [6.25%]. Carcinoma oesophagus was predominantly found in males and lower one third was the commonest site [71.4%]. No patient had involvement of upper third while middle third was involved in 28.6%. Mean age of the patients was 42; age range was 14 to 63. Duration of dysphagia ranged from one day to 35 days; mean duration was 18 days. Upper gastrointestinal endoscopy is a safe and valuable procedure in individuals of all age groups with dysphagia and often leads to positive therapeutic intervention even in quite frail subjects. Benign esophageal stricture, esophagitis and esophageal carcinoma, are the commonest causes of dysphagia in South Punjab