TITLE:
Benign Stenosis of Oesophagus: About 101 Cases in the Digestive Endoscopy Department of the General Idrissa Pouye Hospital (Dakar, Senegal)
AUTHORS:
Mamadou Ngoné Guèye, Mame Anta Camara, Gnagna Diouf, Salamata Diallo, Cheikh Ahmadou Bamba Cissé, Marème Polèle Fall, Mame Aïssé Thioubou, Marie Louise Bassène, Daouda Dial, Mouhamadou Mbengue
KEYWORDS:
Stenosis, Oesophagus, Plummer-Vinson, Dilatation
JOURNAL NAME:
Open Journal of Gastroenterology,
Vol.12 No.1,
January
20,
2022
ABSTRACT: Introduction: Benign oesophageal strictures are defined as
narrowing of the oesophageal lumen not related to neoplastic pathology. They
are frequently encountered during endoscopic practice and are often responsible
for a reduction in the quality of
life of patients due to the appearance of dysphagia. In sub-Saharan Africa, little
data are available on these benign esophageal strictures. The objective of our
study was to determine the sociodemographic, diagnostic and therapeutic aspects
of benign oesophageal strictures in a digestive endoscopy centre in Senegal. Patients
and Methods: This was a retrospective,
descriptive study analysing reports of upper GI endoscopies performed between
January 2015 and December 2017 in a hospital in Senegal. Reports that concluded
to have non-neoplastic oesophageal stenosis were collated. Sociodemographic
data, indications for and results of endoscopy, and therapeutic modalities were collected. These data were analysed using the Sphinx
version 5 software. Results: We collected 101 cases of benign oesophageal
stenosis, representing a prevalence of 2.1% in the endoscopy centre. The mean
age of the patients was 34 years (range 2 and 83 years) with a median of 37.9
years. There was a female predominance with a sex ratio of 0.38 (73 females). Dysphagia, the main symptom, was
present in 87 patients (86.1% of cases) with a Dysphagia score greater than or equal to 2 in 51
patients (50.5%). The average duration of this dysphagia, excluding caustic
stenosis, was 4 years (extremes 1 and 15 years). Endoscopy revealed simple
stenosis in 76 cases (75.2% of cases). A membranous ring of the cervical
oesophagus, suggestive of the Plummer-Vinson syndrome ring, was found in 60
patients (59.4% of cases) and was the primary cause; other aetiologies were
dominated by caustic stenosis (19 cases), Schatzki rings (8 cases) and peptic
stenosis (4 cases). Endoscopic dilatation was performed in 90 patients (89.1%
of cases) with Savary Gilliard bougies (87 cases) and hydrostatic balloons (3
cases). The average number of dilatation sessions was 1.69. In 10 patients
(11.1%), refractory stenosis was observed. This stenosis could be resolved
after further dilatation in 8 cases before the 8th session. In 2 patients,
dilatation failed. Conclusion: Benign oesophageal strictures in our digestive
endoscopy centre in Senegal mainly affect young adults, with a predominance of
women. Diagnosis is often late. Cervical oesophageal rings in the context of
Plummer-Vinson syndrome are the main cause. Oesophageal dilatation with bougies
is of great therapeutic value.