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J Gastroenterol Dig Dis 2017 | Volume 2, Issue 3
World Gastroenterological &
Gastroenterology and Endoscopy
October 30-31, 2017 | Toronto, Canada
World Congress on
Acute obstruction of the oesophagus by an ingested foreign body as the first manifestation of early
and severe radiation esophagitis
Alexandra Deduchova
Jablonec nad Nisou Hospital, Czech Republic
Introduction:
Here we report a case of severe radiation-
induced esophageal toxicity at an early stage after completion
of radiation therapy.
Case Report:
A 80-year old man was presented to the
outpatient Department of Internal Medicine with the chief
complaint of difficulty in swallowing solid food and liquids
and pain in the mid chest for a period of 2 days. The patient’s
oncologic history was significant for locally advanced an
oesophageal tumor. Endoscopic findings revealed semicircle
cancer 25cm from the incisor teeth, which measured
about 5cm, histologically poorly differentiated squamous
cell carcinoma (radiological stage T3N1M0). The patient
was treated with radiotherapy, with intensity modulated
radiation with 6 megavoltage photon beams for cancer of
oesophagus, oesophagus and lymph node with total dose
50, 4 Gy. Two weeks after completed radiotherapy we
performed an urgent endoscopic evaluation of upper GIT
because of acute dysphagia. Endoscopy revealed acute
obstruction by an ingested foreign body (food) on the basis
of radiation-induced esophagitis with stenosis in the mid
part of oesophagus. Impacted food passed by gently pushing
in stenotic lumen with using thin endoscope for nasal
endoscopy. Further treatment was conservative.
Conclusion:
Acute esophageal injury manifest clinically
as dysphagia, odynophagia and substernal discomfort.
Symptoms and endoscopic findings are nonspecific, so
histologic analysis is needed for a definitive diagnosis. Trials
about effect of radioprotective chemical agents have had
conflicting results and are limited by small patient number
and radioprotective agents demonstrated significant side
effects. We need additional studies to define better the
predictors of radiotherapy-induced esophageal injury and
further evaluation of efficacy potentially affective agents
before its broad incorporation into clinical practice.
Speaker Biography
Alexandra Deduchova is a Gastroenterology Specialist graduated and working eight
years in the field Gastroenterology and Internal Medicine in the Czech Republic. She is
a Member in the Czech Society of the Gastroenterology and in the European Society
of Gastroenterology and Endoscopy and she is one of the founders of the Section of
Young Gastroenterologists in the Czech Republic. Her long-term aim is to continue
acquiring the skills necessary for my function as a physician and as an endoscopic
specialist, to publish new knowledge and to gain experience from my practice.
e:
alexandradeduchova@gmail.com