[Radiological and endoscopic study of the esophagus in 33 cases of generalized scleroderma]

The radiological and endoscopic picture of the oesophagus was investigated in 33 patients with generalised sclerodermia. Signs of involvement were noted in 26 subjects, whereas symptoms of such involvement had been observed in 13 only. Screening for oesophageal sclerodermia sites requires accurate assessment of oesophageal kinetics. Fibroscopic examination gives equally reliable evidence of involvement in the form of two distinctive signs: absence of peristaltic contractions in the lower half of the oesophagus and persistence of a "pool of water" in the organ for over 30 secs following injection of a few cc of water in the lying patient. Endoscopy frequently reveals concomitant peptic oesophagitis (10 cases). This is invisible radiologically. Endoscopy also permits accurate appraisal of the lesions associated with peptic stenosis. Fibroscopic examination of the oesophagus, in fact, could well be made a feature of the evaluation of all patients with actual or suspected generalised sclerodermia, on account of its aid to diagnosis and the early notice it gives of oesophageal complications.