What is new in esophageal injury (infection, drug-induced, caustic, stricture, perforation)?

Curr Opin Gastroenterol. 2009 Jul;25(4):372-9.

Abstract

Purpose of review: We will focus separately on infectious, drug-induced and caustic injury of the esophagus and their possible complications such as stricture and perforation.

Recent findings: There has been a decrease in opportunistic esophageal infection in HIV-positive patients, in particular candidiasis, which remains an important cause of inpatient charges, length of stay and total hospital costs, and new antifungal therapy are currently explored. As far as drug-induced esophageal injury is concerned, more than 1000 cases of all cases due to nearly 100 different medications have been described during the last 10 years. However, the estimated case frequency is probably much higher and the related literature is of low quality, as cases are reported selectively and stimulated by clustering of cases, newly implicated pills or unusual complications. Finally, in the field of caustic ingestion-related injury, there has been greater understanding of geographical differences in prevalence and more frequently involved substances, choice of optimal timing for endoscopy, relationship between symptoms and severity of lesions and appropriate role of steroids and other therapies, such as the topical application of mytomicin C.

Summary: This update covers the most relevant papers published on the three areas of interest during the last year.

Publication types

  • Review

MeSH terms

  • Bacterial Infections / complications
  • Bacterial Infections / diagnosis
  • Burns, Chemical / diagnosis*
  • Burns, Chemical / etiology
  • Burns, Chemical / therapy
  • Caustics / toxicity*
  • Combined Modality Therapy
  • Constriction, Pathologic
  • Esophageal Perforation / etiology*
  • Esophageal Perforation / pathology
  • Esophageal Perforation / therapy
  • Esophageal Stenosis / chemically induced*
  • Esophageal Stenosis / physiopathology
  • Esophageal Stenosis / therapy
  • Esophagoscopy
  • Esophagus / injuries
  • Esophagus / microbiology
  • Esophagus / pathology
  • Female
  • Humans
  • Male
  • Mycoses / complications
  • Mycoses / diagnosis
  • Prognosis
  • Recurrence
  • Risk Assessment
  • Treatment Outcome
  • Virus Diseases / complications
  • Virus Diseases / diagnosis

Substances

  • Caustics