Siddique Akbar Satti, Syed Irfan Ahmed, Muhammad Habib, Muhammad Naseemullah.
Flexible Oesophagoscopy in Oesophageal Dysphagia: A 134-Patient Series.
J Rawal Med Coll Jan ;6(1):26-9.

Background: Oesophageal dysphagia is frequently encountered in clinical practice. Unlike oropharyngeal dysphagia, which can be evaluated by non-invasive methods, oesophageal dysphagia needs sophisticated investigations such as barium oesophagography, manometric studies and rigid or flexible oesophagoscopy. We employed flexible oesophagoscopy to determine the cause of dysphagia in our patients and to diagnose treatable conditions such as distal oesophagitis and oesophageal carcinoma at an early stage. Methods: This prospective, multicentre study was conducted on 134 patients (90 males and 44 females), presenting with dysphagia over a period of two years. Only those patients were included where oesophageal dysphagia was suspected on the basis of history, clinical examination and exclusion of oropharyngeal diseases by examination and indirect laryngoscopy. Flexible oesophagoscopy was done in all the cases to determine the cause of oesophageal dysphagia. Results: Forty eight patients (35.82%) had reflux oesophagitis. Benign strictures were present in 14.92% and oesophageal carcinoma in 13.43%. Other causes of dysphagia included achalasia cardia (3.73%), extrinsic compression (5.22%), webs (2.23%) and foreign bodies (3.73%). Majority of the benign strictures (60%) and malignant strictures (77.78%) were found in the lower 1/3rd of oesophagus. No abnormality could be detected in 28 (20.89%) patients. Conclusions: A variety of conditions can lead to oesophageal dysphagia, which cannot be predicted simply on the basis of history and clinical examination. Evaluation in cases of oesophageal dysphagia remains incomplete without oesophagoscopy. We consider it a necessary procedure, which needs to be urgently performed so that serious, but potentially treatable conditions like malignancy are diagnosed as early as possible.

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