Clinical Endoscopy

Review

Role of endoscopy in eosinophilic esophagitis: Eun-Jin Yang, Kee Wook Jung; Clin Endosc 2025;58(1):1-9. Published online July 5, 2024; DOI: https://doi.org/10.5946/ce.2024.023

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease involving inflammation of the esophagus. Endoscopy is essential in the diagnosis and treatment of EoE and shows typical findings, including esophageal edema, rings, exudates, furrows, and stenosis. However, studies involving pediatric and adult patients with EoE suggest that even a normally appearing esophagus can be diagnosed as EoE by endoscopic biopsy. Therefore, in patients with suspected EoE, biopsy samples should be obtained from the esophagus regardless of endoscopic appearance. Moreover, follow-up endoscopies with biopsy after therapy initiation are usually recommended to assess response. Although previous reports of endoscopic ultrasonography findings in patients with EoE have shown diffuse thickening of the esophageal wall, including lamina propria, submucosa, and muscularis propria, its role in EoE remains uncertain and requires further investigation. Endoscopic dilation or bougienage is a safe and effective procedure that can be used in combination with medical and/or dietary elimination therapy in patients with esophageal stricture for the management of dysphagia and to prevent its recurrence.

Citations

Citations to this article as recorded by

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Original Article

Health-Care Utilization and Complications of Endoscopic Esophageal Dilation in a National Population: Abhinav Goyal, Kshitij Chatterjee, Sujani Yadlapati, Shailender Singh; Clin Endosc 2017;50(4):366-371. Published online March 17, 2017; DOI: https://doi.org/10.5946/ce.2016.155

Abstract PDF PubReader ePub

Background
/Aims: Esophageal stricture is usually managed with outpatient endoscopic dilation. However, patients with food impaction or failure to thrive undergo inpatient dilation. Esophageal perforation is the most feared complication, and its risk in inpatient setting is unknown.
Methods
We used National Inpatient Sample (NIS) database for 2007–2013. International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes were used to identify patients with esophageal strictures. Logistic regression was used to assess association between hospital/patient characteristics and utilization of esophageal dilation.
Results
There were 591,187 hospitalizations involving esophageal stricture; 4.2% were malignant. Endoscopic dilation was performed in 28.7% cases. Dilation was more frequently utilized (odds ratio [OR], 1.36; p<0.001), had higher in-hospital mortality (3.1% vs. 1.4%, p<0.001), and resulted in longer hospital stays (5 days vs. 4 days, p=0.01), among cases of malignant strictures. Esophageal perforation was more common in the malignant group (0.9% vs. 0.5%, p=0.007). Patients with malignant compared to benign strictures undergoing dilation were more likely to require percutaneous endoscopic gastrostomy or jejunostomy (PEG/J) tube (14.1% vs. 4.5%, p<0.001). Palliative care services were utilized more frequently in malignant stricture cases not treated with dilation compared to those that were dilated.
Conclusions
Inpatient endoscopic dilation was utilized in 29% cases of esophageal stricture. Esophageal perforation, although infrequent, is more common in malignant strictures.

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Clinical Transplantation.2020;[Epub] CrossRef
Five-year single-centre experience of carcinoma of the oesophagus from Blantyre, Malawi
John David Chetwood, Peter J Finch, Anstead Kankwatira, Jane Mallewa, Melita A Gordon, Leo Masamba
BMJ Open Gastroenterology.2018; 5(1): e000232. CrossRef
Safe and Proper Management of Esophageal Stricture Using Endoscopic Esophageal Dilation
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15,206 View
135 Download
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