M Diagnosis

^^ Endoscopic diagnostic criteria (Figs. 3.30-3.35)

► Concentric or eccentric narrowing (Figs. 3.30, 3.35)

► Surface alterations

► Pseudodiverticulum proximal to the stricture (Fig. 3.32)

Differential diagnosis

► Malignant stricture

Checklist for endoscopic evaluation

► Distance of the stricture from the incisors

► Diameter (using biopsy forceps as a measure)

► Resistance to instrument passage

► Gross evidence of malignant change?

Additional Studies

Comments

A peptic stricture often requires endoscope treatment (see Dilation, p. 172).

Fig. 3.30 Peptic stricture of the esophagus

Fig. 3.31 Peptic stricture of the esophagus

Fig. 3.30 Peptic stricture of the esophagus

Fig. 3.31 Peptic stricture of the esophagus

Fig. 3.32 Chronic reflux esophagitis.

Pseudodiverticulum proximal to the stricture

Esophageal Pseudodiverticulum

Fig. 3.34 Peptic stricture of the esophagus. Retroflexed view

Fig. 3.35 Distal esophageal ring. Most likely a result of chronic inflammatory changes. Fresh erythematous changes are also present

Fig. 3.33 Peptic stricture of the esophagus. Retroflexed view

Fig. 3.34 Peptic stricture of the esophagus. Retroflexed view

Fig. 3.35 Distal esophageal ring. Most likely a result of chronic inflammatory changes. Fresh erythematous changes are also present

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