1/38. Esophageal candidoma in a patient with acquired immunodeficiency syndrome.Oral thrush and esophagitis caused by candida are common in patients infected with the human immunodeficiency virus. We present the case of a 33-year-old man with acquired immunodeficiency syndrome who developed dysphagia during a hospitalization for pneumonia. signs and symptoms were consistent with candida esophagitis. Despite therapy with fluconazole, the patient's symptoms persisted. At upper endoscopy, a 1-cm, polypoid esophageal mass at 30 cm from the incisors and several other nodular lesions were observed; white plaques were noted throughout the esophagus. biopsy specimens of the mass contained hyphal forms consistent with candida species. Therapy with amphotericin b improved the patient's symptoms, and resolution of the mass was confirmed by repeat upper endoscopy. We believe this is the first case in the medical literature of a candida mass (candidoma) causing dysphagia in a patient with acquired immunodeficiency syndrome. Candidoma should be considered in the differential diagnosis of dysphagia in patients with human immunodeficiency virus infection or immunosuppression due to other causes.- - - - - - - - - - ranking = 1keywords = esophagitis (Clic here for more details about this article) |
2/38. Complete dysphagia after thrombolytic treatment for myocardial infarction.An 82 year old man was admitted to hospital with unstable angina pectoris. There was a long history of minor symptoms suggesting reflux disease, with a small diaphragmatic hernia. One day after admission the patient complained of severe chest pain. An acute inferior-posterior myocardial infarction was diagnosed on ECG, and thrombolytic treatment with alteplase (rt-PA) was initiated. Within a few hours total dysphagia occurred, caused by haemorrhagic oesophagitis. The haematoma resolved spontaneously within about 10 days. The patient was discharged three weeks later after full resolution of the dysphagia.- - - - - - - - - - ranking = 0.5keywords = esophagitis (Clic here for more details about this article) |
3/38. Esophageal lichen planus: case report and review of the literature.Involvement of the esophagus by lichen planus is a rarely reported condition. The histologic features of esophageal lichen planus, which may differ from those of cutaneous disease, have only rarely been illustrated. We describe a 58-year-old woman with skin and oral lichen planus who presented with dysphagia and an esophageal stricture that were ultimately diagnosed as esophageal lichen planus. Multiple esophageal biopsies demonstrated a lichenoid, T cell-rich lymphocytic infiltrate, along with degeneration of the basal epithelium and Civatte bodies. Correct diagnosis of esophageal lichen planus is critical because of its prognostic and therapeutic distinction from other more common causes of esophagitis and stricture formation.- - - - - - - - - - ranking = 0.5keywords = esophagitis (Clic here for more details about this article) |
4/38. An operation for the treatment of intractable peptic stricture of the esophagus.The current management of severe strictures of the esophagus resulting from reflux esophagitis is unsatisfactory. A new operation comprising esophagoplasty and intrathoracic fundoplication is described. This preliminary report records the results of this operation in 10 patients. There was one operative death. Of the nine survivors, followed for six months to three years, seven are completely free of symptoms. The remaining two have mild residual symptoms, but no dysphagia.- - - - - - - - - - ranking = 0.5keywords = esophagitis (Clic here for more details about this article) |
5/38. Esophageal inflammatory pseudotumor mimicking malignancy.A 54-year-old man with a complaint of dysphagia was found to have a prominent stricture in the proximal esophagus. A biopsy of the stenotic area indicated sarcoma, leading to subtotal esophagectomy. The surgically removed esophagus demonstrated a well-defined intramural mass, consisting of a mixture of fibroblastic cells with bland cytological appearances and inflammatory cells. Reflux esophagitis which was present distal to the stricture seemed to play a role in the development of this inflammatory pseudotumor.- - - - - - - - - - ranking = 0.5keywords = esophagitis (Clic here for more details about this article) |
6/38. Esophageal intramural pseudodiverticulosis: review of symptoms including upper gastrointestinal bleeding.BACKGROUND: Esophageal intramural pseudodiverticulosis (EIP) is a rare condition manifested by multiple, flask-shaped outpouchings in the wall of the esophagus, which represent dilated excretory ducts of esophageal mucous glands. STUDY: Five patients with EIP were evaluated with regard to symptoms and concomitant diseases, as well as endoscopic, radiologic, and manometric findings. RESULTS: Primary clinical symptoms reported by the five patients (three men and two women; age range, 59-72 years) were increasing dysphagia ( n = 3), upper gastrointestinal bleeding ( n = 1), and no symptoms ( n = 1). Concomitant diseases were chronic alcoholism ( n = 3), diabetes mellitus ( n = 1), and reflux esophagitis ( n = 1). Primary diagnosis was made endoscopically in all cases. Endoscopic findings other than pseudodiverticula were esophageal webs ( n = 2) and proximal esophageal stenoses ( n = 4). The typical radiologic findings were detectable in two patients, pathologic manometric findings were seen in only one patient. The authors treated the concomitant diseases and performed endoscopic dilatations of esophageal stenoses. One case with initial bleeding from an associated web is described in detail. According to our knowledge, this is the first publication of a case of EIP-associated bleeding. CONCLUSION: Esophageal intramural pseudodiverticulosis is a differential diagnosis in cases of dysphagia and/or esophageal strictures if no other causes are found. The authors think that endoscopy is the method of choice for establishing the diagnosis.- - - - - - - - - - ranking = 0.5keywords = esophagitis (Clic here for more details about this article) |
7/38. Dysphagia in Crohn's disease: a diagnostic challenge.Dysphagia is a rare manifestation in a patient with Crohn's disease. We report on the case of a patient with long-standing Crohn's disease who developed progressive dysphagia over 3 years. endoscopy showed minimal distal oesophagitis with non-specific histological findings. Further investigation with cinematography, barium swallow and manometry established an achalasia-like motility disorder. Biopsies obtained from the oesophagus were non-specific. Balloon dilatation was performed. Initial success was followed by recurrent dysphagia. At repeat endoscopy, an oesophageal fistula was detected. An attempt at conservative medical management failed and oesophagectomy was successfully performed. pathology results of the resected specimen confirmed the suspected diagnosis of oesophageal Crohn's disease. Even if achalasia is suspected in a Crohn's patient, it should be taken into consideration that the motility disorder could be the result of a transmural inflammation with or without fibrosis caused by Crohn's disease.- - - - - - - - - - ranking = 0.5keywords = esophagitis (Clic here for more details about this article) |
8/38. Fragility of the esophageal mucosa: a pathognomonic endoscopic sign of primary eosinophilic esophagitis?BACKGROUND: Primary eosinophilic esophagitis, a chronic inflammatory disorder of the esophagus, evokes recurrent dysphagia. endoscopy is often unremarkable, and no consensus exists regarding management of resultant dysphagia. The response of a series of patients with primary eosinophilic esophagitis to dilation is reported together with a description of a possibly pathognomonic sign: fragile esophageal mucosa, for which the term "crepe-paper" mucosa is introduced. methods: Five men underwent endoscopy because of dysphagia confirmed (clinically, endoscopically, and histologically) to be caused by primary eosinophilic esophagitis and were treated by bouginage. OBSERVATIONS: All patients had extremely fragile, inelastic, and delicate mucosa, which tore easily even with minor trauma. After the procedure, patients remained asymptomatic for 3 to 24 months. CONCLUSIONS: Primary eosinophilic esophagitis is characterized by fragile esophageal mucosa that readily tears in response to minor trauma during otherwise uneventful diagnostic endoscopy. This "crepe-paper" sign may alert endoscopists to the presence of the disease when other mucosal alterations are lacking. Dilation is effective for patients with symptoms with minimal morbidity, despite development of disquieting lesions in response to the procedure.- - - - - - - - - - ranking = 4keywords = esophagitis (Clic here for more details about this article) |
9/38. Mediastinal mass with Dysphagia in an elderly patient.We report the use of endoscopic techniques for successful diagnosis in a case of atypical esophageal tuberculosis. tuberculosis of the esophagus is an unusual presentation of this disease, having been estimated to occur in 0.15% of the people who die of tuberculosis. A few cases of possible primary tuberculous esophagitis have been described. This report describes a patient with dysphagia who appeared to have esophageal tuberculosis without hiv and in the absence of other signs of tuberculosis. The patient responded promptly to treatment with tuberculostatics.- - - - - - - - - - ranking = 0.5keywords = esophagitis (Clic here for more details about this article) |
10/38. doxycycline-induced pill esophagitis.Pill-induced esophagitis is a complication seen in patients who use certain medications such as tetracycline and non-steroidal anti-inflammatory drugs. In this short report, we described five cases of doxycycline-induced esophagitis with endoscopic images. All of the patients were young or middle-aged women. Dysphagia or odynophagia with retrosternal pain were the main presenting symptoms in all cases. The observed injuries were at the middle third of esophagus with a normal surrounding mucosa. All patients had a history of swallowing the capsule with a small amount of water or in a recumbent position. Two patients with dysphagia were managed by intravenous fluid support and parenteral acid suppression. The symptoms were improved in 2-7 days after the ceasing of the drug and control endoscopies were completely normal in all cases after 3-4 weeks of admission. The drug-induced esophagitis is not rare with certain drugs and should be suspected in all patients presenting with chest pain and dysphagia. physicians must warn the patients to take the pills and capsules with enough liquid and in the upright position.- - - - - - - - - - ranking = 3.5keywords = esophagitis (Clic here for more details about this article) |
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