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Oesophageal stricture

Oesophageal strictures refer to any persistent intrinsic narrowing of the oesophagus



The most common causes are fibrosis induced by inflammatory and neoplastic processes. Because radiographic findings are not reliable in differentiating benign from malignant strictures, all should be evaluated endoscopically. 

Upper and middle oesophageal strictures most commonly result from 

Distal oesophageal strictures are typically caused by gastro-oesophageal reflux disease (GORD), either as a separate entity, or in the setting of:

Radiographic features

Benign strictures: 

  • smoothly tapering
  • typically concentric narrowing, but may affect only one side of the oesophagus (asymmetric wall rigidity)

Malignant strictures are characteristically

  • abrupt
  • asymmetric
  • eccentric with irregular, nodular mucosa

Tapered margins may occur with malignant lesions because of the ease of submucosal spread of tumour.

Oesophageal strictures are often associated with a hiatal hernia.

Treatment and prognosis

The risk of Barrett oesophagus in a stricture is 20-40% and strictures should be evaluated endoscopically.

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