Acute obstruction of the oesophagus by an ingested foreign body as the first manifestation of early and severe radiation esophagitis
Joint Event on World Gastroenterological & World Congress on Gastroenterology and Endoscopy
October 30-31, 2017 | Toronto, Canada
Alexandra Deduchova
Jablonec nad Nisou Hospital, Czech Republic
Scientific Tracks Abstracts : J Gastroenterol Dig Dis
Abstract:
Introduction: Here we report a case of severe radiationinduced 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.
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.
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