Contribution of Esophagram to the Evaluation of Complicated Pediatric Eosinophilic Esophagitis.
Contribution of Esophagram to the Evaluation of Complicated Pediatric Eosinophilic Esophagitis.
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DOI：
10.1097/mpg.0000000000000849
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发表时间：
2015-11
影响因子：
2.9
通讯作者：
Fenton LZ
中科院分区：
文献类型：
--
作者：
Menard-Katcher C;Swerdlow MP;Mehta P;Furuta GT;Fenton LZ
与消化性狭窄不同的是，EoE患者的临床显著狭窄可能是微小的，在内窥镜检查时无法识别。我们的目标是确定与对比食道造影术相比，内窥镜检查发现狭窄的频率。我们回顾了6年来在三级儿科医院就诊的所有EoE食道狭窄患者的食道造影和内窥镜检查，这些患者在3个月的时间内完成了这两项手术。回顾临床病理资料，包括年龄、症状持续时间、组织学和治疗。22名患有EoE相关狭窄的儿童完成了食道造影和内窥镜检查。在这些儿童中，55%的食道狭窄是通过食道造影而不是内窥镜来识别的。仅在食道造影发现狭窄的患者的症状持续时间(2.1年持续时间比5.4年持续时间，p=0.03)比内窥镜确定的组短。术前发现狭窄的放射学特征与更多的扩张术有关。食道造影是评估复杂EoE患儿食道解剖的一项有价值的检查。与内窥镜检查相比，食管镜检查可以更早地发现细微的纤维狭窄。
In contrast to peptic strictures, clinically significant strictures in patients with EoE may be subtle and go unrecognized at the time of endoscopy. We aimed to identify how often stricture was identified by endoscopy as compared to contrast esophagram. We retrospectively reviewed esophagram and endoscopy examinations of all EoE patients with esophageal stricture seen at a tertiary care pediatric hospital over a 6 year period who had both procedures completed within a 3-month time frame. Medical charts were reviewed for clinicopathologic information including age, duration of symptoms, histology and treatment. Twenty-two children with EoE associated stricture completed both esophagram and endoscopic assessments. Esophageal strictures were identified by esophagram, and not endoscopy, in 55% of these children. Patients with stricture identified at esophagram alone had a shorter duration of symptoms (2.1 years duration vs. 5.4 years duration, p = 0.03) than the group identified by endoscopy. Pre-operative radiographic identification of a stricture was associated with dilation more often being performed. Esophagram is a valuable test to assess esophageal anatomy in children with complicated EoE. Esophagram may be able to detect subtle fibrostenosis earlier in the natural history of the disease than endoscopy.