ABSTRACT
Fibrovascular polyps of the esophagus are benign, pedunculated tumors that consist mostly of connective tissue and can reach impressive sizes. They arise from the upper third of the esophagus and may produce symptoms of dysphagia, progressive weight loss and regurgitation. The most serious clinical presentation is asphyxia secondary to laryngeal obstruction. Despite their size, diagnosis may be difficult. The location of the stalk and the vascularity makes surgical resection the preferred mode of removal of these unusual polyps.
Subject(s)
Esophageal Neoplasms , Polyps , Esophageal Neoplasms/diagnosis , Esophageal Neoplasms/pathology , Esophageal Neoplasms/surgery , Esophagoscopy , Esophagostomy , Female , Humans , Middle Aged , Polyps/diagnosis , Polyps/pathology , Polyps/surgeryABSTRACT
OBJECTIVE: Despite the introduction of effective medical treatment of peptic ulcer disease, bleeding is still a frequent complication. The aim of this study was to investigate whether the incidence and the risk profile of peptic ulcer haemorrhage have changed within a 10-year period. MATERIAL AND METHODS: In a prospective epidemiological and observational study the incidence and risk profile of peptic ulcer haemorrhage in Düsseldorf, Germany were compared between two time periods (period A: 1.3.89-28.2.90 and period B: 1.4.99-31.3.2000), involving nine hospitals with both surgical and medical departments. Patients with proven peptic ulcer haemorrhage at endoscopy or operation were included in the study; those with bleeding under defined severe stress conditions were excluded. RESULTS: No differences in bleeding ulcer incidence were observed between periods A and B (51.4 per 100,000 person-years versus 48.7), or for duodenal ulcer (24.9 versus 25.7) or for gastric ulcer bleeding (26.5 versus 23.0). A marked increase in incidence rates was observed with increasing age. In period B, patients with bleeding ulcers were older (56% versus 41% 70 years or older), were usually taking non-steroidal anti-inflammatory drugs (NSAIDs) (45% versus 27%) and were less likely to have a history of ulcer (25% versus 59%) compared with patients in period A. CONCLUSIONS: The persisting high incidence of peptic ulcer disease is a superimposing of two trends: a higher incidence in the growing population of elderly patient with a higher intake of NSAIDs and a lower incidence among younger patients due to a decrease in incidence and improved medical treatment.
