THROAT - Oesophageal strictures

Oesophageal strictures can be divided into:

I) Caustic stricture
II) Strictures secondary to esophagitis and reflux

I) Caustic stricture
Aetiology: Ingestion of caustic agents such as dye, drain openers, acids.

Diagnosis:
a) History of ingestion
b) Symptoms : Shock, burning sensation
c) Endoscopy to determine the damage

what is the treatment of Oesophageal strictures?

Treatment:
Medical
a) Neutralising agent
b) Corticosteroids and broad spectrum antibiotics for 3-6 weeks
c) Barium swallow of the oesophagus performed after 10-14 days to determine development of stricture.

Surgical
a) Dilatation of stricture if present
b) Oesophageal replacement surgery with colon or stomach may be necessary

II. Secondary strictures to esophagitis and reflux:
Pathophysiology :
a) Usually al gastro-oesophageal junction
b) In severe cases long stricture may result

Diagnosis :
a) History of reflux symptoms and dysphagia is suggestive of strictures
b) Barium swallow of the oesophagus confirms the diagnosis
c) Oesophagoscopy is important to determine the extent of disease and rule out malignancy

Treatment:
a) Dilatation of the oesophagus is attempted first and antireflux operation is performed
b) Reconstructive surgery using stomach




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