Sgouros S N, Bergele C, Mantides A
Department of Gastroenterology, Athens Naval and Veterans Hospital, Athens, Greece.
Endoscopy. 2006 May;38(5):515-20. doi: 10.1055/s-2006-924983.
Eosinophilic esophagitis is a condition that is being increasingly recognized in adults. The main presenting symptoms are dysphagia (93 %), food impaction (62 %), and heartburn (24 %). A history of allergy is obtained in 52 % of patients and peripheral eosinophilia is found in 31 % of patients with this condition. Esophageal manometric studies have provided evidence of a nonspecific motility disorder in 40 % of patients. Endoscopic findings include mucosal fragility or edema (59 %), solitary or multiple concentric rings (49 %), strictures (40 %), whitish pinpoint exudates or papules (16 %), and a small-caliber esophagus (5 %); 9 % of patients present with a normal endoscopy. Esophageal dilation in adults with eosinophilic esophagitis has limited efficacy and is associated with an increased complication rate compared with dilation in patients with benign strictures. The administration of inhaled or systemic corticosteroids results in symptomatic improvement in nearly 95 % of patients. A trial with corticosteroids before bougienage may reduce active inflammation and therefore the complication rate of the procedure.
嗜酸性粒细胞性食管炎是一种在成人中越来越被认识到的疾病。主要的临床表现为吞咽困难（93%）、食物嵌塞（62%）和烧心（24%）。52%的患者有过敏史，31%的患者外周血嗜酸性粒细胞增多。食管测压研究表明40%的患者存在非特异性动力障碍。内镜检查结果包括黏膜脆弱或水肿（59%）、单发或多发同心环（49%）、狭窄（40%）、白色点状渗出物或丘疹（16%）以及食管腔狭窄（5%）；9%的患者内镜检查正常。与良性狭窄患者相比，嗜酸性粒细胞性食管炎成人患者的食管扩张疗效有限且并发症发生率增加。吸入或全身应用糖皮质激素可使近95%的患者症状改善。在探条扩张术前使用糖皮质激素进行试验可能会减轻活动性炎症，从而降低该手术的并发症发生率。
