Clinical Analysis Of175Cases Of Benign Esophageal Ulcer

Objective By analyzing the clinical characteristics of benign esophageal ulcer inorder to improve the understanding of the disease and it，s etiology,expecting to achieveearly diagnosis,early treatment,improve the prognosis.Methods The clinical data of175patients with benign esophageal ulcersdiagnosed by gastroscope in our hospital were retrospectively reviewed.Results Our hospital endoscope room from January2010to February2014werediagnosed by endoscopic biopsy175cases of benign esophageal ulcer,male124cases,while51cases of female,male and female in the ratio of2.4:1,age range from17to89years old,the median age at the age of64.The cases of benign esophageal ulcerwere mainly caused by reflux esophagitis(98cases,56%),followed by unknowncauses(47cases,26.86%),12cases of esophageal injury,8cases of esophageal infection,7cases of inflammatory disease,esophageal submucosal tumor with ulcer,esophagealachalasia and pemphigus each1case.The group of reflux esophagitis was mostly in themiddle aged and elderly people,elder than50years old,81cases(82.65%) while thegroup of unknown causes was mostly in young adults,under the age of50,34cases(72.33%), difference had statistical significance (P<0.005).The symptoms ofdigestive system about patients of this group were priority to substernal discomfort,heartburn (97cases,55.43%), followed by reflux,difficultly in swallowing, odynophagia,dysphagia, epigastric abdominal pain, nausea, vomiting, haematemesis,hiccups, etc.Theulcers on endoscopy of the reflux esophagitis were usually located in the lower segmentof esophagus (88cases,89.80%), multiple (63cases,64.28%), the shape of the ulcersmore linear or stripe (71cases,72.45%), followed by irregular, round, circumferential,etc.The ulcers of the unknown causes were in the middle (23cases,48.93%), single (33 cases,70.21%), the shape more round(29cases,61.70%), followed by irregular, strip orlongitudinal, etc.The location of the two groups had significant difference (P<0.005).6cases of viral esophageal were located in the middle (3cases), multiple (4cases), roundor oval (5cases), all like "volcanic-shaped ulcers";3cases of esophageal crohn’s diseasewere mainly located in the middle and lower segment, multiple (2cases), irregular,different sizes, surrounding mucosa had hyperplasia or uplift,the pathologic appearancewithout typically granuloma.3cases of esophageal Behcet’s disease,2cases in themiddle,single, oval and round,1case in the lower,multiple,longitudinal;1case ofsuspected eosinophilic esophagitis, in the lower,single,round,esophageal biopsydiagnostic with numerous eosinophils;3cases of drug-induced esophagitis located in themiddle,2cases single, round and longitudinal,1case multiple, four,round.138cases ofthis group were positive in the Hp test,accounting for84.66%. The group of refluxesophagitis was mostly accompanied with hiatal hernia (24cases), followed by pepticulcer (13cases), gastrointestinal reflux, glycuresis, fungal esophagitis, etc.The patientsof reflux esophagitis reviewed after regular therapy were46cases,30cases improved(65.22%),10cases recurrent,6cases aggravated (3cases Barrett,s esophagus,3casesmild-medium dysplasia);The patients of non reflux esophagitis reviewed,15cases ofunknown causes,3cases of drug-induced esophagitis,5cases of foreign bodies in theesophagus and1case of radioactive esophagitis reviewed were healed after the regulartreatment of acid-suppression and mucosal protective medication;3cases of virusinfection, improved after antiviral and conventional treatment;2cases of esophagealcrohn’s disease improved after hormone therapy;2cases of esophageal Behcet’ s diseaseimproved after treated by hormone and thalomid respectively;1cases of achalasiaimproved after treated by calcium channel blocker and mucosal protective drugs;1caseof pemphigus improved after the treatment of hormone and mucosal protective drugs.Conclusion1. The reflux esophagitis is the main cause of benign esophagealulcers;2.The benign esophageal ulcers unexplained are more common among the youngadults，located in the middle segment mostly.It should be wary of crohn’s disease,Behcet’s disease, eosinophilic esophagitis and such specific diseases in whom without obvious improvement after regular treatment.