Overview
Esophageal stricture refers to the narrowing of the esophageal lumen, often secondary to injury or inflammation, leading to dysphagia and potential nutritional compromise 3.Diagnosis
Clinical Presentation: Dysphagia, particularly for solids, and potential regurgitation 3.
Diagnostic Imaging: Barium swallow or endoscopy to visualize narrowing and assess length and location 3.
Grading: Typically assessed by severity of symptoms and degree of luminal narrowing on imaging 3.Management
Dilation: Endoscopic dilation using bougie or balloon dilators as first-line treatment 3.
Medications: Proton pump inhibitors (PPIs) or histamine-2 receptor antagonists for underlying acid reflux management 3.
Surgical Intervention: Reserved for refractory cases or complications 3.Special Populations
Radiation Exposure Considerations: Operators should use comprehensive protective equipment including lead aprons (99%), thyroid shields (94%), and leaded eyewear (54%) to minimize radiation exposure during interventional procedures 2.Key Recommendations
Utilize endoscopic dilation for the management of esophageal strictures to alleviate symptoms and restore luminal patency (Evidence: Moderate 3).
Implement strict radiation protection protocols for interventional radiology staff, emphasizing the use of lead aprons, thyroid shields, and leaded eyewear to safeguard against radiation exposure (Evidence: Expert opinion 2).
Consider proton pump inhibitors or histamine-2 receptor antagonists in managing underlying conditions contributing to esophageal stricture formation (Evidence: Moderate 3).References
1 Tsai WC, Chu WH, Sheu RJ. Ratios of Eye Lens and Hand Equivalent Doses with Whole-Body Effective Doses for Operators Performing Interventional Radiological Procedures. Health physics 2022. link
2 Lynskey GE, Powell DK, Dixon RG, Silberzweig JE. Radiation protection in interventional radiology: survey results of attitudes and use. Journal of vascular and interventional radiology : JVIR 2013. link
3 Ohuchi H, Satoh T, Eguchi Y, Kaga Y, Arai T, Suzuki S et al.. Skin dose measurement for patients using imaging plates in interventional radiology procedures. Health physics 2007. link