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By C G Bremner
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20 Intramural pseudodiverticulosis. Numerous small outpouchings (arrow) due to dilated submucous glands, probably the result of chronic inflammation. (With permission from Mayo Foundation, Johnson CD. Alimentary Tract Imaging: A Teaching File. ) 18 6. Bremner et al. SEGMENTAL NARROWING The three most common causes of dysphagia are cancer, benign stricture, and motility disorders. A careful clinical history will frequently provide clues to narrow the differential diagnosis. Dysphagia to solid foods is more common in mechanical narrowing, such as cancer or benign strictures, whereas difficulty with both solids and liquids more likely indicates a motility disorder.
Vadva MD, Triadafilopoulos G. Glycogenic acanthosis of the esophagus and gastroesophageal reflux. J Clin Gastroenterol 1993; 17:79 – 83. 2. ESOPHAGITIS: ENDOSCOPIC GRADING . . Los Angeles Classification Grade A: Mucosal breaks confined to the mucosal fold, each not longer than 5 mm; Grade B: At least one mucosal break longer than 5 mm, confined to the mucosal fold but not continuous between the folds; Grade C: Mucosal breaks that are continuous between the tops of mucosal folds; Grade D: Extensive mucosal breaks engaging at least 75% of the esophageal circumference.
37. 38. 2 Esophageal Endoscopy 1. ENDOSCOPY Endoscopic evaluation is necessary to confirm or establish a diagnosis in most esophageal disorders. 1. Specific Indications* A. B. C. D. E. F. G. H. I. J. , anorexia and weight loss) or in patients over 45 years of age; Dysphagia or odynophagia; Esophageal reflux symptoms, which are persistent or recurrent despite appropriate therapy; Persistent vomiting of unknown cause; Other diseases in which the presence of upper gastrointestinal (GI) pathology might modify other planned management.