The Yield of Endoscopy and Histology in the Evaluation of Esophageal Dysphagia: Two Referral Centers’ Experiences

Medicina

Fahmi Shibli¹  Fadi Abu Baker²  Tawfik Khoury³  Amir Shahin³  Wisam Sbeit³  Helal Said Ahmad⁴  Amir Mari⁴  Ali Omari⁵  Yazed Jawabreh⁵  Rand Abboud⁶ 

[1] Department of Gastroenterology and Liver Disease, Emek Medical Center, Afula 1855701, Israel;Department of Gastroenterology, Hillel Yaffe Medical Center, Hadera 38100, Israel;Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel;Gastroenterology and Endoscopy Units, The Nazareth Hospital, EMMS, Nazareth 16100, Israel;Internal Medicine Department, The Nazareth Hospital, EMMS, Nazareth 16100, Israel;Surgery Department, The Nazareth Hospital, EMMS, Nazareth 16100, Israel;

关键词: dysphagia;    gastroscopy;    diagnosis;    eosinophilic esophagitis;    endoscopic findings;   

DOI  :  10.3390/medicina57121336

来源: DOAJ

【 摘 要 】

Background and Objectives: The initial diagnostic test required to evaluate esophageal dysphagia is upper endoscopy (EGD) to assess the structure of the esophagus and the esophageo-gastric junction (EGJ). Taking biopsies during EGD has become a common practice in patients with dysphagia to rule out eosinophilic esophagitis (EoE). The aims of this study were to evaluate the endoscopic findings of patients who underwent EGD for esophageal dysphagia, to assess the rate of biopsy taking from the esophagus to diagnose/exclude EoE, and to report histology outcomes of these biopsies. Materials and Methods: This was a retrospective multicenter study that included individuals ≥18 years who underwent EGD due to esophageal dysphagia between the years 2015 and2020, (with no other alarm signs, such as weight loss, new iron deficiency anemia, and lymphadenopathy). We obtained data from patients’ electronic files. The endoscopy and histology findings were obtained from endoscopy reports saved in our electronic files. Results: A total of 209 patients were included in the study. The average age was 57.1 ± 17.1 years. The most common endoscopic findings were normal endoscopy in 76 patients (36.4%) and erosive esophagitis in 75 patients (35.9%). Barrett’s esophagus and esophageal malignancy were encountered in 11 patients (5.3%) and 2 patients (0.95%), respectively. Esophageal biopsies were taken in 50.2% of patients, and one patient had histological evidence of EoE (0.5%). On univariate analysis, there was a trend for association between proton pump inhibitors (PPIs) use and a normal EGD, but it was not statistically significant (OR 0.28, 95% CI 0.07–1.11, p = 0.07). Conclusions: Endoscopic findings were prevalent in dysphagia patients even when no other alarm symptoms exist. Neoplastic lesions and EOE were rare in our study.

【 授权许可】

Unknown