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Esophageal motility disorders missed during endoscopy
Hirofumi Abe1, Shinwa Tanaka2, Fumiaki Kawara3
1Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan. abe627@med.kobe-u.ac.jp.
Esophagus : Official Journal of the Japan Esophageal Society
|January 17, 2022
Summary
Fifteen percent of esophageal motility disorders were missed during endoscopic examination. Identifying these missed cases through clinical characteristics can improve diagnostic accuracy and patient outcomes.
Area of Science:
- Gastroenterology
- Esophageal Physiology
- Diagnostic Endoscopy
Background:
- Esophageal motility disorders are often challenging to diagnose during standard endoscopic procedures.
- Misdiagnosis can lead to delayed or incorrect treatment for patients.
Purpose of the Study:
- To determine the proportion of esophageal motility disorders that are missed during endoscopic evaluation.
- To identify the clinical characteristics associated with these missed diagnoses.
Main Methods:
- Retrospective analysis of patients diagnosed with esophagogastric junction outflow obstruction or major disorders of peristalsis via high-resolution manometry.
- Definition of missed esophageal motility disorders as any endoscopic misdiagnosis within one year prior to manometry.
- Multivariate analysis to identify predictors of missed diagnoses.
Main Results:
- 15.0% of esophageal motility disorders were missed during endoscopy within a year before manometric diagnosis.
- Independent predictors for missed diagnoses included non-dilated esophagus, epiphrenic diverticulum, transnasal endoscopy use, and combined esophagram use.
Conclusions:
- A significant proportion of esophageal motility disorders are overlooked during endoscopy.
- Understanding specific clinical features can aid endoscopists in identifying at-risk patients and improving diagnostic yield.
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