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It Is Better Keeping in Mind Than Being Delayed for Therapy. Uncommon Cause of Associated Dysphagia a Stricture, Report of Two Cases and Review of the Literature

34

Torres, Diana MD; Hani, Albis MD; Rey, Samuel MD; Alvarado, Jaime MD; Canadas, Raul MD; Solano, Claudia MD

American Journal of Gastroenterology: September 2006 - Volume 101 - Issue - p S53
Abstracts: ESOPHAGUS
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Gastroenterologia, Hospital Universitario San Ignacio Pontificia Universidad Javeriana, Bogota, Cundinamarca, Colombia and Gastroenterologia, Instituto De Seguros Sociales, Bogota, Cundinamarca, Colombia.

Purpose: There is an increasing amount of information about novel diagnostic tools or therapeutic regimens for several diseases, but we believe not to remember each condition's real source, may be originating huge mistakes such as not recognizing the appropriate decision about individual patient care. To find patients who had suffered associated dysphagia a stricture among our health care patients is not unusual. In this condition, that has several causes, the reflux as a cause is adduced frequently. Nevertheless, if we extend our mind to other probabilities, we will see how the outcome of our medical act improves, diminishing the delay in the true diagnose. This is reflected in getting to provide the best and opportune treatment, but the most important thing is that this side reflects in better life quality for the patient. In the cases we are reviewing, a unusual cause of dysphagia associated to stricture is the lichen planus that jeopardizes the esophagus. Lichen planus is a common disorder of squamous epithelium but its involvement of the esophagus is uncommon. We reported two women with this condition, middle aged, without commitment of skin and oral lichen planus, whose presented with disphagia slowly progressive, evaluation endoscopic revealed stricture, biopsies demonstrated a lichenoid infiltrate, along with degeneration of the basal epithelium and Civatte bodies and their reflux test (pH metria) negative. The well informed approach helped our patients to receive the best therapeutic intervention available. Remember “health care professionals need information to keep up dated … ” but we have to keep in mind …. All subjects are equally relevant, from listening to the patient with an outstanding clinic record to taking the proper approach with the better therapy.

© The American College of Gastroenterology 2006. All Rights Reserved.