Ilaç kullanimina bagli gelisen özofagus hasari
Drug-induced esophageal injury
Özet
Giris ve amaç: Muhtelif yakinmalar ve endikasyonlar ile endoskopi ünitemize basvuran ve özofagogastroduodenoskopi (ÖGD) yapilan olgulari n arasinda ilaç kullanimi sonucu meydana gelmis özofageal yaralanmalari n irdelenmesi. Gereç ve yöntem: Agustos 2001- Subat 2004 döneminde endoskopi ünitemizde ÖGD yapilmis toplam 6475 hastanin kayitlari ve histopatolojik degerlendirilmeleri retrospektif olarak incelendi. Bulgular: 6475 hastanin 23’ünde (% 0.35) ilaca bagli özofageal ülser ve özofajit bulgulari saptandi. Hastalarin 13’ü (% 58) kadin, 10’u (% 42) erkekti. Yas ortalamasi 51.26 ± 18.43 ( 22-71) idi. 23 olgunun 9’unda (% 41) tetrasiklin ve doksisiklin, 6’sinda (%25) alendronat, 2’sinde (%8) potasyum klorür, 2’sinde (%8) ibuprofen ve 4’ünde (%17) aspirin kullani mi belirlendi. Orta özofageal segmentte bir veya daha fazla sayida ülserasyon ve erozyonlar tipik endoskopik bulgular idi. Histopatolojik incelemenin rapor ettigi bulgular inflamasyon ve reaktif hiperplazi seklinde idi. Sonuç: Retrosternal yanma, gögüs agrisi, odinofaji ve disfaji yaki nmalari ile basvuran hastalarda ilaç kullanimi sorgulanmali ve buna bagli olarak gelisebilecek özofagus patolojileri hatirlanmalidir.
Abstract
Background/aim: To evaluate drug-induced esophageal injuries among patients subjected to esophagogastroduodenoscopy because of different complaints and indications of referral to our endoscopy unit. Materials and methods: Esophagogastroduodenoscopy records and histopathologic reports of 6475 patients referred to our endoscopy unit between August 2001 and February 2004 were evaluated retrospectively. Results: In 23 patients (23/6475, 0.35%), drug- induced esophageal ulcer and esophagitis were detected. Gender distribution of the patients was 13 (58%) females and 10 (42%) males. Median age of these patients was 51.26 ± 18.43 years (range: 22-71). Nine (43%) of these patients used tetracycline and doxycycline, 6 (25%) alendronate, 2 (8%) potassium chloride, 2 (8%) ibuprofen and 4 (17%) aspirin. Single or multiple ulcerations and area(s) of erosion in the middle esophageal segment were the typical findings of endoscopic evaluation. The most prominent histopathological changes were inflammation and reactive hyperplasia. Conclusion: Patients with complaints of retrosternal burning, chest pain and odynophagia should be questioned regarding their recent use of medications, and possibility of drug-induced esophageal injuries should be remembered.
