Oesophageal stricture

Oesophageal strictures refer to any persistent intrinsic narrowing of the oesophagus

Pathology

Aetiology

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

These most commonly result from:

Distal oesophageal strictures

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

Associations

Oesophageal strictures are often associated with a hiatal hernia.

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.

Treatment and prognosis

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


Oesophageal pathology
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Article Information

rID: 1767
Section: Pathology
Tag: oesophagus
Synonyms or Alternate Spellings:
  • Esophageal stricture
  • Oesophageal strictures
  • Esophageal strictures
  • Peptic stricture
  • Peptic strictures

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    Case 1: post corrosive stricture
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    Scleroderma with ...
    Case 2: malignant (proximal) & peptic (distal)
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    Case 3: peptic stricture
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    Case 4: secondary to correction atresia
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