[Barrett's esophagus associated to caustic stenosis of the esophagus].
BACKGROUND
The esophageal stenosis secondary to the ingestion of caustic products is frequent in Brazil, mainly due to an attempt suicide. The Barrett's esophagus is consequence of the chronic gastroesophageal reflux. The literature consulted showed that are a rare association.


METHODS
From 1981 to 2000 were admitted and treated in the "Gastrocentro" State University of Campinas, SP, Brazil, 120 patients presenting caustic stenosis of the esophagus, and during the follow-up were found nine cases with Barrett's esophagus associated (7,5%). The time of caustic ingestion varied from 4 years to 54 years (mean 29 years), and they were four males and five females, eight whites and one black, with the mean age of 57,7 years (43 to 72 years).


RESULTS
All the cases presented dysphagia and the flexible upper endoscopy showed stenotic areas and caustic esophagitis sequels. Three patients referred symptoms of gastroesophageal reflux, but hiatus hernia were found in only one case. The Barrett's esophagus was found in the middle third of the esophagus above the stenotic areas in three cases, and in the distal third in six cases. The dysphagia was treated with periodic esophageal dilatations. Two patients presenting severe symptoms of reflux were submitted to modified Nissen fundoplication by videolaparoscopy, with good results.


CONCLUSIONS
The Barrett's esophagus in these patients could be associated to the caustic ingestion, because it is not situated in the distal third of the esophagus, as commonly found in reflux esophagitis. Its is very important the follow-up and biopsies of the Barrett's esophagus, due to the possibility of malignancy.
Andreollo
Nelson Adami
NA
Departamento de Cirurgia e Gastrocentro, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP. nandreollo@hotmail.com
Lopes
Luiz Roberto
LR
Tercioti
Valdir
V
Brandalise
Nelson Ary
NA
Leonardi
Luiz Sérgio
LS
D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000209:etiology*; D002057:Burns, Chemical / Q000150:complications*; D002424:Caustics / Q000506:poisoning*; D004940:Esophageal Stenosis / Q000139:chemically induced* / Q000150:complications; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged
D002424:Caustics