[Update in the endoscopic management of benign esophageal stenoses].
Correction of dysphagia in benign esophageal stenosis without the need for surgery is a task that has been tried to be resolved for more than three centuries; in the last three decades this management has evolved with the development of pneumatic dilators and, more recently, alternative and adjuvant treatments like local steroid injection, electrocoagulation, use of argon plasma and the use of expandable stents have been added. The most common causes of benign esophageal stenosis are peptic esophagitis in first place followed by the ingestion of caustic substances; other less frequent etiologies are medication ingestion, stenosis secondary to a surgical anastomosis of the esophagus and stenosis related to mediastinal radiotherapy; the rarest causes include esophageal rings and membranes, sclerotherapy for esophageal varices, the prolonged use of a nasogastric tube, Crohn's disease, among others. A complete clinical, radiological and endoscopic evaluation of the patient is required to make the diagnosis, with the respective complimentary histopathologic study. At present, traditional esophageal dilatations, as well as pneumatic dilatations are the most common and effective treatments, the previously mentioned alternative and adjuvant treatments are used in exceptional cases, some with advantages over the others depending on each patient in particular and on the characteristics and etiology of the stenosis. The future seems to be aimed at the use of temporary expandable stents.
De la Garza González
Salvador Javier
SJ
Departamento de Gastroenterología, Centro Médico del Hospital San José, Monterrey, N.L. drsalvadordelagarza@prodigy.net.mx
García
Rafael Guevara
RG
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000368:Aged; D002057:Burns, Chemical / Q000150:complications; D002404:Catheterization; D002986:Clinical Trials as Topic; D000075202:Contraindications; D004106:Dilatation / Q000295:instrumentation; D004564:Electrocoagulation; D004940:Esophageal Stenosis / Q000139:chemically induced / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D004942:Esophagitis, Peptic / Q000150:complications; D004945:Esophagoscopy / Q000379:methods; D005471:Fluoroscopy; D006801:Humans; D019919:Prosthesis Implantation; D011788:Quality of Life; D015607:Stents
D000305:Adrenal Cortex Hormones