高度な食道狭窄を呈したBarrett食道の1例

抄録

We report a patient of Barrett's esophagus with sever stenosis.
A 89 years old male was admitted to our department because of dysphagia on June 19th, 2003. Esophagoscopy revealed a sever middle esophagus stenosis at the level of 27cm from incisors. Esophagogram showed membranate esophageal stricture and sliding hiatal hernia. On June 28th, First balloon dilation was performed. Squamocolumnar junction was observed at the anal side of the stenosis and lower esophagus was lined by columnar epithelium almost 7cm length. Biopsy specimen revealed columnar epithelium with intestinal metaplasia. Therefore we diagnosed as Barrett's esophagus. After two times of balloon dilation he could ingest and discharged. Almost one week after his discharge, dysphagia was exacerbated again. Esophagoscopy revealed restenosis of esophagus, so further two times of esophageal dilation were added. After four times of balloon dilation, esophagogram showed good passege of the esophagus and esophagoscopy revealed improvement of stenosis and remaining of ulcer scar. Double stained by Methylene blue and iodine showed squamocolumnar junction cleary at the stricture point.
We reported the case of Barrett's esophagus with a sever stenosis. Repeated endoscopic balloon dilation was seemed effective in benign esophagus stenosis.