STENOSE PEPTIQUE: ETAT DES LIEUX

Abstract

Oesophageal peptic stenosis (PS) is a benign and rare complication of chronic gastroesophageal reflux disease (GERD). Upper digestive endoscopy plays a crucial role in the diagnostic and therapeutic management of this pathology. The aim of this study is to describe the epidemiological, endoscopic and evolutionary aspects of PS in our context. Methods: This is a retrospective study realized over a period of 18 years [January 2002-August 2020], including all patients diagnosed as PS. The dilatation was performed by Savary-Gilliard candles or hydrostatic balloons. Results: We included 137 patients.The mean age was 50.2 years [16-88years] with a male predominance (sex ratio M/F of 1.15). one hundred and twenty-nine dilatation procedures were performed. A history of chronic GERD was present in 77% of the patients with a mean duration of 6 years [1-17 years]. The reason behind consultation of our patients was dysphagia in all cases regurgitation in 77% and pyrosis in 25%. The upper endoscopy showed an impassable stenosis in 74.5% and a surmountable stenosis in 25.5% of the cases. The stenosis located in the lower third of esophagus in 75% of the cases, with an average extent of stenosis of 3.5 cm. All our patients were put on proton pump inhibitor (PPI). Dilatation was made bycandles with progressive diameters in 63% and by balloons in 37.2%. The evolution was marked by a clinical improvement in 64.7% of the patients with recurrence in 30% requiring other endoscopic dilatation sessions. No complications were reported. Conclusion: Peptic stenosis is a benign complication of GERD. Endoscopic dilatation associated with PPI is the optimal treatment with good functional results.