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Titel: Gastrointestinal: BougieCap passage for calibration of an endoscopically equivocal peptic stricture/Schatzki ring
VerfasserIn: Zimmer, V.
Sprache: Englisch
Titel: Journal of Gastroenterology and Hepatology
Bandnummer: 35
Heft: 5
Seiten: 708-708
Verlag/Plattform: Wiley
Erscheinungsjahr: 2019
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: A 54-year-old man presented subacutely with long-standing dysphagia after presumed spontaneous resolution of esophageal bolus obstruction 2 days before. Esophago-gastric-duodenoscopy initially indicated free esophageal passage into a larger hiatal hernia. Because the Z line could not be properly visualized in standard fashion, careful inversion within the hernia excluded active reflux disease with an unremarkable squamocolumnar junction. During slow withdrawal in the distal esophagus, a questionable short stricture/Schatzki ring (Figure 1a) came to our attention being highlighted by a scarring aspect in the vicinity and a superficial mucosal lesion, most likely reminiscent of the preceding food impaction (Fig. 1b). To better assess for the true esophageal diameter, we proceeded with esophageal BougieCap passage as a novel accessory dome-shaped cap for endoscopy-guided esophageal bougienage, potentially combining diagnostics and therapeutics in individual equivocal cases of esophageal luminal compromise. Given the formidable stature of the patient measuring 6 ft 3 in. in height, we chose a 16-mm BougieCap (Ovesco Endoscopy, Tübingen, Germany) for advancement without guidewire assistance. There was minor resistance during passage of the peptic stricture as reflected by the ring-shaped whitening of the mucosa with a minor tear at the 3 o'clock position, thus confirming functional relevance of the lesion under direct endoscopic vision (Fig. 1c). Endoscopic stricture assessment is known to be unreliable in borderline cases. Functional lumen imaging probe as the currently most reliable tool to this end is not widely available, thus limiting its routine use in stricture evaluation. Given that unrestricted swallow function typically depends on luminal width of 14 to 16 mm, BougieCap passage using such a cap size range might contribute to an endoscopic one-stop calibration of luminal diameter and same-time treatment, if appropriate.
DOI der Erstveröffentlichung: 10.1111/jgh.14896
URL der Erstveröffentlichung: https://onlinelibrary.wiley.com/doi/full/10.1111/jgh.14896
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-363313
hdl:20.500.11880/32997
http://dx.doi.org/10.22028/D291-36331
ISSN: 1440-1746
0815-9319
Datum des Eintrags: 2-Jun-2022
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Innere Medizin
Professur: M - Keiner Professur zugeordnet
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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