Esophageal stricture causes and pattern of presentation at Ibn Sina Specialized Hospital

Abstract

Introduction: The aim of this study is to evaluate the causes and pattern of presentation of esophageal stricture in Ibn Sina Specialized Hospital. Methods:This is a retrospective study done at Ibn Sina Specialized Hospital during the period from April 2008 to December 2008. All patients had upper gastrointestinal endoscopy (UGIE), and those who were found to have esophageal stricture were enrolled in the study. The data collected were then processed and analyzed using appropriate statistical tests. Results and discussion: Out of 780 patients who had UGIE, 60 were found to have esophageal stricture; 37(61.6%) were males. The age group ranged between 20 years and 89 years, with a mean (± SD) age of 50.483 (±17.437) years. Esophageal cancer of the squamous cell carcinoma type (SCC) was the most important cause of stricture in the study. In both genders, the cancer was common in the elder age groups. Dysphagia was the commonest presenting symptom. Malignant and benign strictures were located at different site of the esophagus. In males postsclerotherapy was more common especially in the young, while peptic stricture was common in elderly. In females peptic stricture and esophageal webs were common in young adults (20 – 50 years). Endoscopic dilatation was performed successfully to 59 patients. Only one male in the age group 60 – 69 years was managed with percutaneous endoscopic gastrostomy (PEG) tube due to failure of dilatation. Conclusion: Esophageal stricture is an alarming sign of malignancy. Post-SCC stricture was detected in a considerable number of patients in our study group, therefore it require careful early diagnosis and distinction from other varieties because of their good outcome. Adenocarcinoma and other malignant tumors which cause esophageal stricture were not detected in our study group.
Alcohol consumption was not a significant risk factor contributing to the development of post-SCC stricture in this study. Post-sclerotherapy stricture represented the peak in male farmers residing in the center of Sudan compared to females, other occupations and regions, and to other causes of benign stricture.

Keywords: dysphagia, schistosmaisis, achalasia, adenocarcinoma, squamous.