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RISK OF ENDOSCOPIC COMPLICATIONS IN PATIENTS WITH EOSINOPHILIC ESOPHAGITIS
C Williams, M Dupre, GG Kaplan, CN Andrews, E Shaffer, PL Beck
Division of Gastroenterology, University of Calgary, Calgary, AB
BACKGROUND: Eosinophilic esophagitis (EoE) appears to be an increasingly recognized cause of dysphagia and food impaction. Although, there has been several case reports of esophageal tears and perforations associated with EoE, the risk of endoscopic complications has not been formally assessed.
AIM: Determine the risk of endoscopic complications in EoE patients undergoing upper endoscopy (EGD) +/– dilatation.
METHODS: 186 cases of EoE were identified in the Calgary Health Region between 2002 and 2006. At the time of submission of this abstract, a full chart review was completed on 52 patients; representing 85 EGD’s which included 13 esophageal dilations.
RESULTS: Of the 52 EoE patients studied; 86.5% were male, average age was 40.2 y (range 16-78 y), allergies were noted in 32.7% (9.6% food allergies, 23.1% had drug or environmental allergies), asthma in 17.3% and autoimmune diseases in 7.7%. 75% presented with dysphagia and 13.5% presented with a food bolus impaction. Classic endoscopic features of EoE were documented in 80.8% of patients. An average of 3.4 biopsies was taken per procedure. The only complication that was recorded for all of the procedures was a single esophageal tear that occurred with biopsy. The patient was not symptomatic and was discharged home in standard fashion following the procedure. No perforations were noted and the patients tolerated all procedures well. Further data will be available at the time of the meeting.
CONCLUSION: This is the first study to specifically assess the endoscopic complications in EoE. In this report on 85 EGDs, that included 13 esophageal dilations, the only reported complication was a single esophageal tear noted with biopsy. Further analysis of our other 134 patients should be completed by the time of the meeting, providing a more detailed assessment of the endoscopic risk in EoE.