Esophageal ulcers are a rare cause of upper gastrointestinal bleeding.
In this study, investigators from Detroit, Michigan, describe the etiology, treatment, complications, and outcome of esophageal ulcers.
Esophageal ulcers were observed in 88 patients, from a total of 7564 esophagogastroduodenoscopies performed between 1991 and 2001.
The team found that the etiology of esophageal ulcers included gastrointestinal reflux disease (GERD) (66%), drug induced (23%), candidal (3%), and caustic injury (2%).
|17% of patients required endoscopic intervention.|
|Journal of Gastrointestinal Surgery|
They determined that the mean size of GERD-induced esophageal ulcers and drug-induced esophageal ulcers was 2.78 and 2.92 cm, respectively.
The investigators found that 80% of GERD-induced and 14% of drug-induced ulcers occurred in the lower thoracic esophagus.
Morbidity included hemorrhage, esophageal stricture, and esophageal perforation.
The researchers established that nonoperative therapy sufficed in 92% of patients.
Overall, 17% of patients required endoscopic intervention. This included esophageal dilatation for stricture and endoscopic hemostasis for esophageal bleeding.
Surgical therapy was reserved for patients with esophageal stricture and perforation.
Dr Daisuke Higuchi's team concluded, "GERD and drug ingestion are common causes of esophageal ulcers".
"Midesophageal ulcers have a greater tendency to hemorrhage compared with ulcers at the gastroesophageal junction; this may reflect the etiology".
"Strictures complicate GERD-induced esophageal ulcers but not drug-induced esophageal ulcers".
"Esophageal dilatation is an effective treatment for most strictures associated with esophageal ulcers".
"Esophageal ulcers rarely cause death".