A study of clinical and endoscopic findings in benign strictures of middle and lower thirds of esophagus

Introduction: The aim of this study was to assess the clinical profile of patients with benign strictures of middle and lower thirds of esophagus , to analyse the grade of dysphagia and site of stricture by barium swallow and to describe the endoscopic and histopathological findings in them Methods: It was a prospective, cross sectional, descriptive study where thirty patients with benign structural esophageal dysphagia of middle and lower thirds were studied. Clinical features and etiology was assessed.Barium swallow and endoscopy were carried out to delineate the stricture. Then histopathological specimens taken from site of stricture were analysed. Observations and Results: The commonest etiology of benign esophageal dysphagia was found to be peptic stricture(43.33%). Corrosive (23.33%) and post sclerotherapy strictures (20%) followed suit. 53.85% patients with peptic strictures had dysphagia grade II. Patients with corrosive strictures had dysphagia grade III-V. Most patients were poorly built with 56.67% patients having a weight of less than 40 kg. The mean weight of patients in this study was 42.1 + 10.6. On barium swallow,most of the patients had strictures in lower end of esophagus (68%) . 19 patients had short strictures ( 63.33%) while only 9 had long ones.. On endoscopy,5 strictures were very tight (16.67%) ( less than 6 mm) and 12 were tight (40%) ( 7 to 10mm) and the corrosive strictures were long and tortuous. Fibrosis was the common histopathological finding. Conclusion: Peptic strictures were mostly smooth and short while corrosive ones were narrow, long and tortuous.Histopathology also showed mostly fibrosis and non specific infiltrate.