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Histologic and Manometric Studies on the Esophagus Following Endoscopic Sclerotherapy

Sharma, Peeyush; Hagerstrand, Inga LU and Sharma, Dave Krishan (2009) In Digestive Diseases and Sciences 54(8). p.1713-1719
Abstract
Objective The aim of this work was to study the histologic and manometric changes in the distal esophagus beyond 2 years following endoscopic sclerotherapy (EST) and/or surgical intervention, and to try to understand the etiological factors associated with these changes. Patients and interventions Forty patients, with an average age of 61.5 years, were studied for 2-12 years following sclerotherapy and/or surgical intervention. The causes of liver disease were alcoholic cirrhosis (78.6%), primary biliary cirrhosis (14.3%), and chronic aggressive hepatitis (7.1%). A predominant number of cases (65%) had a mesocaval interposition shunt due to the failure of EST, 32.5% EST alone, and 2.5% esophageal devascularization. All patients had... (More)
Objective The aim of this work was to study the histologic and manometric changes in the distal esophagus beyond 2 years following endoscopic sclerotherapy (EST) and/or surgical intervention, and to try to understand the etiological factors associated with these changes. Patients and interventions Forty patients, with an average age of 61.5 years, were studied for 2-12 years following sclerotherapy and/or surgical intervention. The causes of liver disease were alcoholic cirrhosis (78.6%), primary biliary cirrhosis (14.3%), and chronic aggressive hepatitis (7.1%). A predominant number of cases (65%) had a mesocaval interposition shunt due to the failure of EST, 32.5% EST alone, and 2.5% esophageal devascularization. All patients had esophageal manometry following mucosal biopsies taken in duplicate endoscopically from three levels of the distal esophagus. Results In the EST and shunt groups, 88.5% had manometric abnormalities, esophagitis, and chronic inflammatory changes. In the EST group, all but two patients had manometric abnormalities and chronic inflammatory changes. Analysis of the patient groups on the basis of the number of EST sessions and the amount of sclerosant injected showed that both histologic changes and dysmotility were more profound in those treated over five times with EST. The differences were significant. Conclusion It appears that EST causes persistent manometric abnormalities and chronic inflammatory changes in the distal esophagus, the severity of which seems to vary directly with the frequency of sclerotherapy and not amount of sclerosant injected. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
sphincter (LES), Lower esophageal, Manometry, Endoscopic sclerotherapy (EST), Esophagus, Peristalsis, Histology
in
Digestive Diseases and Sciences
volume
54
issue
8
pages
1713 - 1719
publisher
Springer
external identifiers
  • wos:000267485400016
  • scopus:67649945532
ISSN
1573-2568
DOI
10.1007/s10620-008-0536-z
language
English
LU publication?
yes
id
4aec8367-a9ff-4d67-9f88-63e6c2f99e74 (old id 1463316)
date added to LUP
2009-08-31 11:03:51
date last changed
2017-01-01 04:35:32
@article{4aec8367-a9ff-4d67-9f88-63e6c2f99e74,
  abstract     = {Objective The aim of this work was to study the histologic and manometric changes in the distal esophagus beyond 2 years following endoscopic sclerotherapy (EST) and/or surgical intervention, and to try to understand the etiological factors associated with these changes. Patients and interventions Forty patients, with an average age of 61.5 years, were studied for 2-12 years following sclerotherapy and/or surgical intervention. The causes of liver disease were alcoholic cirrhosis (78.6%), primary biliary cirrhosis (14.3%), and chronic aggressive hepatitis (7.1%). A predominant number of cases (65%) had a mesocaval interposition shunt due to the failure of EST, 32.5% EST alone, and 2.5% esophageal devascularization. All patients had esophageal manometry following mucosal biopsies taken in duplicate endoscopically from three levels of the distal esophagus. Results In the EST and shunt groups, 88.5% had manometric abnormalities, esophagitis, and chronic inflammatory changes. In the EST group, all but two patients had manometric abnormalities and chronic inflammatory changes. Analysis of the patient groups on the basis of the number of EST sessions and the amount of sclerosant injected showed that both histologic changes and dysmotility were more profound in those treated over five times with EST. The differences were significant. Conclusion It appears that EST causes persistent manometric abnormalities and chronic inflammatory changes in the distal esophagus, the severity of which seems to vary directly with the frequency of sclerotherapy and not amount of sclerosant injected.},
  author       = {Sharma, Peeyush and Hagerstrand, Inga and Sharma, Dave Krishan},
  issn         = {1573-2568},
  keyword      = {sphincter (LES),Lower esophageal,Manometry,Endoscopic sclerotherapy (EST),Esophagus,Peristalsis,Histology},
  language     = {eng},
  number       = {8},
  pages        = {1713--1719},
  publisher    = {Springer},
  series       = {Digestive Diseases and Sciences},
  title        = {Histologic and Manometric Studies on the Esophagus Following Endoscopic Sclerotherapy},
  url          = {http://dx.doi.org/10.1007/s10620-008-0536-z},
  volume       = {54},
  year         = {2009},
}