Miniprobe ultrasonography for determining prognosis in corrosive esophagitis.
OBJECTIVE
We evaluated the ability of endoscopic ultrasonography to predict likelihood of stricture formation in patients with corrosive esophagitis.


METHODS
Consecutive patients with esophagitis resulting from alkaline or acid chemical ingestion (n = 11) were evaluated prospectively by endoscopic ultrasonography between hospital days 4 and 12. Findings for the most severe lesion were classified according to the appearance of the muscular layers: distinct muscular layers without thickening (grade 0); distinct muscular layers with thickening (grade I); obscured muscular layers with indistinct margins (grade II); and muscular layers that could not be differentiated (grade III). Findings were also classified according to whether apparent damage to muscular layers in the worst-appearing image involved part of the circumference (type a) or the whole circumference (type b). Implications of these findings for subsequent stricture formation were then evaluated.


RESULTS
Stricture formation did not occur in patients with grade 0 or grade I images; transient stricture formation occurred in a patient showing grade IIa. Stricture requiring repeated bougie dilation occurred in a patient showing grade IIIb.


CONCLUSIONS
Endoscopic ultrasonographic images presumed to reflect the destruction of muscular layers (grades II to III), as opposed to only edema (grade I), may be associated with stricture formation. This modality can accurately visualize deep lesions in corrosive esophagitis, making it prognostically useful.
Kamijo
Yoshito
Y
Department of Emergency and Critical Care Medicine, Kitasato University, School of Medicine, Kanagawa, Japan.
Kondo
Ichiei
I
Kokuto
Mikio
M
Kataoka
Yuichi
Y
Soma
Kazui
K
D000328:Adult; D000368:Aged; D002424:Caustics / Q000009:adverse effects*; D019160:Endosonography / Q000379:methods*; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D004941:Esophagitis / Q000139:chemically induced* / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index
D002424:Caustics