Prevalence of eosinophilic oesophagitis in adults presenting with oesophageal food bolus obstruction
Identifieur interne : 000250 ( Pmc/Corpus ); précédent : 000249; suivant : 000251Prevalence of eosinophilic oesophagitis in adults presenting with oesophageal food bolus obstruction
Auteurs : Neel Heerasing ; Shok Yin Lee ; Sina Alexander ; Damian DowlingSource :
- World Journal of Gastrointestinal Pharmacology and Therapeutics [ 2150-5349 ] ; 2015.
Abstract
AIM: To look at the relationship between eosinophilic oesophagitis (EO) and food bolus impaction in adults.
METHODS: We retrospectively analysed medical records of 100 consecutive patients who presented to our hospital with oesophageal food bolus obstruction (FBO) between 2012 and 2014. In this cohort, 96 were adults (64% male), and 4 paediatric patients were excluded from the analysis as our centre did not have paediatric gastroenterologists. Eighty-five adult patients underwent emergency gastroscopy. The food bolus was either advanced into the stomach using the push technique or retrieved using a standard retrieval net. Biopsies were obtained in 51 patients from the proximal and distal parts of the oesophagus at initial gastroscopy. All biopsy specimens were assessed and reviewed by dedicated gastrointestinal pathologists at the Department of Pathology, University Hospital Geelong. The diagnosis of EO was defined and established by the presence of the following histological features: (1) peak eosinophil counts > 20/hpf; (2) eosinophil microabscess; (3) superficial layering of eosinophils; (4) extracellular eosinophil granules; (5) basal cell hyperplasia; (6) dilated intercellular spaces; and (7) subepithelial or lamina propria fibrosis. The histology results of the biopsy specimens were accessed from the pathology database of the hospital and recorded for analysis.
RESULTS: Our cohort had a median age of 60. Seventeen/51 (33%) patients had evidence of EO on biopsy findings. The majority of patients with EO were male (71%). Classical endoscopic features of oesophageal rings, furrows or white plaques and exudates were found in 59% of patients with EO. Previous episodes of FBO were present in 12/17 patients and 41% had a history of eczema, hay fever or asthma. Reflux oesophagitis and benign strictures were found in 20/34 patients who did not have biopsies.
CONCLUSION: EO is present in approximately one third of patients who are admitted with FBO. Biopsies should be performed routinely at index endoscopy in order to pursue this treatable cause of long term morbidity.
Url:
DOI: 10.4292/wjgpt.v6.i4.244
PubMed: 26558158
PubMed Central: 4635164
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PMC:4635164Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Prevalence of eosinophilic oesophagitis in adults presenting with oesophageal food bolus obstruction</title><author><name sortKey="Heerasing, Neel" sort="Heerasing, Neel" uniqKey="Heerasing N" first="Neel" last="Heerasing">Neel Heerasing</name></author><author><name sortKey="Lee, Shok Yin" sort="Lee, Shok Yin" uniqKey="Lee S" first="Shok Yin" last="Lee">Shok Yin Lee</name></author><author><name sortKey="Alexander, Sina" sort="Alexander, Sina" uniqKey="Alexander S" first="Sina" last="Alexander">Sina Alexander</name></author><author><name sortKey="Dowling, Damian" sort="Dowling, Damian" uniqKey="Dowling D" first="Damian" last="Dowling">Damian Dowling</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26558158</idno><idno type="pmc">4635164</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4635164</idno><idno type="RBID">PMC:4635164</idno><idno type="doi">10.4292/wjgpt.v6.i4.244</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000250</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000250</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Prevalence of eosinophilic oesophagitis in adults presenting with oesophageal food bolus obstruction</title><author><name sortKey="Heerasing, Neel" sort="Heerasing, Neel" uniqKey="Heerasing N" first="Neel" last="Heerasing">Neel Heerasing</name></author><author><name sortKey="Lee, Shok Yin" sort="Lee, Shok Yin" uniqKey="Lee S" first="Shok Yin" last="Lee">Shok Yin Lee</name></author><author><name sortKey="Alexander, Sina" sort="Alexander, Sina" uniqKey="Alexander S" first="Sina" last="Alexander">Sina Alexander</name></author><author><name sortKey="Dowling, Damian" sort="Dowling, Damian" uniqKey="Dowling D" first="Damian" last="Dowling">Damian Dowling</name></author></analytic><series><title level="j">World Journal of Gastrointestinal Pharmacology and Therapeutics</title><idno type="ISSN">2150-5349</idno><idno type="eISSN">2150-5349</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>AIM: To look at the relationship between eosinophilic oesophagitis (EO) and food bolus impaction in adults.</p><p>METHODS: We retrospectively analysed medical records of 100 consecutive patients who presented to our hospital with oesophageal food bolus obstruction (FBO) between 2012 and 2014. In this cohort, 96 were adults (64% male), and 4 paediatric patients were excluded from the analysis as our centre did not have paediatric gastroenterologists. Eighty-five adult patients underwent emergency gastroscopy. The food bolus was either advanced into the stomach using the push technique or retrieved using a standard retrieval net. Biopsies were obtained in 51 patients from the proximal and distal parts of the oesophagus at initial gastroscopy. All biopsy specimens were assessed and reviewed by dedicated gastrointestinal pathologists at the Department of Pathology, University Hospital Geelong. The diagnosis of EO was defined and established by the presence of the following histological features: (1) peak eosinophil counts > 20/hpf; (2) eosinophil microabscess; (3) superficial layering of eosinophils; (4) extracellular eosinophil granules; (5) basal cell hyperplasia; (6) dilated intercellular spaces; and (7) subepithelial or lamina propria fibrosis. The histology results of the biopsy specimens were accessed from the pathology database of the hospital and recorded for analysis.</p><p>RESULTS: Our cohort had a median age of 60. Seventeen/51 (33%) patients had evidence of EO on biopsy findings. The majority of patients with EO were male (71%). Classical endoscopic features of oesophageal rings, furrows or white plaques and exudates were found in 59% of patients with EO. Previous episodes of FBO were present in 12/17 patients and 41% had a history of eczema, hay fever or asthma. Reflux oesophagitis and benign strictures were found in 20/34 patients who did not have biopsies.</p><p>CONCLUSION: EO is present in approximately one third of patients who are admitted with FBO. Biopsies should be performed routinely at index endoscopy in order to pursue this treatable cause of long term morbidity.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">World J Gastrointest Pharmacol Ther</journal-id><journal-id journal-id-type="publisher-id">WJGPT</journal-id><journal-title-group><journal-title>World Journal of Gastrointestinal Pharmacology and Therapeutics</journal-title></journal-title-group><issn pub-type="ppub">2150-5349</issn><issn pub-type="epub">2150-5349</issn><publisher><publisher-name>Baishideng Publishing Group Inc</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26558158</article-id><article-id pub-id-type="pmc">4635164</article-id><article-id pub-id-type="other">jWJGPT.v6.i4.pg244</article-id><article-id pub-id-type="doi">10.4292/wjgpt.v6.i4.244</article-id><article-categories><subj-group subj-group-type="heading"><subject>Observational Study</subject></subj-group></article-categories><title-group><article-title>Prevalence of eosinophilic oesophagitis in adults presenting with oesophageal food bolus obstruction</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Heerasing</surname><given-names>Neel</given-names></name></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>Shok Yin</given-names></name></contrib><contrib contrib-type="author"><name><surname>Alexander</surname><given-names>Sina</given-names></name></contrib><contrib contrib-type="author"><name><surname>Dowling</surname><given-names>Damian</given-names></name></contrib><aff>Neel Heerasing, Department of Gastroenterology, Alfred Hospital, Melbourne, VIC 3004, Australia</aff><aff>Neel Heerasing, Shok Yin Lee, Sina Alexander, Damian Dowling, Department of Gastroenterology, University Hospital Geelong, Geelong, VIC 3220, Australia</aff></contrib-group><author-notes><fn><p>Author contributions: Heerasing N and Lee SY contributed equally to the writing of the manuscript as well as analyzing the data; Alexander S and Dowling D provided valuable comments when reviewing the manuscript.</p><p>Correspondence to: Dr. Neel Heerasing, Department of Gastroenterology, Alfred Hospital, 55 Commercial Road, Prahran, Melbourne, VIC 3004, Australia. <email>neel.heerasing@gmail.com</email></p><p>Telephone: +61-3-90762000 Fax: +61-3-90762757</p></fn></author-notes><pub-date pub-type="ppub"><day>6</day><month>11</month><year>2015</year></pub-date><pub-date pub-type="epub"><day>6</day><month>11</month><year>2015</year></pub-date><volume>6</volume><issue>4</issue><fpage>244</fpage><lpage>247</lpage><history><date date-type="received"><day>24</day><month>4</month><year>2015</year></date><date date-type="rev-recd"><day>31</day><month>8</month><year>2015</year></date><date date-type="accepted"><day>1</day><month>10</month><year>2015</year></date></history><permissions><copyright-statement>©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.</copyright-statement><copyright-year>2015</copyright-year></permissions><abstract><p>AIM: To look at the relationship between eosinophilic oesophagitis (EO) and food bolus impaction in adults.</p><p>METHODS: We retrospectively analysed medical records of 100 consecutive patients who presented to our hospital with oesophageal food bolus obstruction (FBO) between 2012 and 2014. In this cohort, 96 were adults (64% male), and 4 paediatric patients were excluded from the analysis as our centre did not have paediatric gastroenterologists. Eighty-five adult patients underwent emergency gastroscopy. The food bolus was either advanced into the stomach using the push technique or retrieved using a standard retrieval net. Biopsies were obtained in 51 patients from the proximal and distal parts of the oesophagus at initial gastroscopy. All biopsy specimens were assessed and reviewed by dedicated gastrointestinal pathologists at the Department of Pathology, University Hospital Geelong. The diagnosis of EO was defined and established by the presence of the following histological features: (1) peak eosinophil counts > 20/hpf; (2) eosinophil microabscess; (3) superficial layering of eosinophils; (4) extracellular eosinophil granules; (5) basal cell hyperplasia; (6) dilated intercellular spaces; and (7) subepithelial or lamina propria fibrosis. The histology results of the biopsy specimens were accessed from the pathology database of the hospital and recorded for analysis.</p><p>RESULTS: Our cohort had a median age of 60. Seventeen/51 (33%) patients had evidence of EO on biopsy findings. The majority of patients with EO were male (71%). Classical endoscopic features of oesophageal rings, furrows or white plaques and exudates were found in 59% of patients with EO. Previous episodes of FBO were present in 12/17 patients and 41% had a history of eczema, hay fever or asthma. Reflux oesophagitis and benign strictures were found in 20/34 patients who did not have biopsies.</p><p>CONCLUSION: EO is present in approximately one third of patients who are admitted with FBO. Biopsies should be performed routinely at index endoscopy in order to pursue this treatable cause of long term morbidity.</p></abstract><kwd-group><kwd>Oesophagitis</kwd><kwd>Eosinophilia</kwd><kwd>Food bolus obstruction</kwd><kwd>Endoscopy</kwd><kwd>Dysphagia</kwd></kwd-group></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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