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Lower esophageal strictures, benign or malignant?

C S Ho, P R Rodrigues

    Journal of the Canadian Association of Radiologists
    |June 1, 1980
    PubMed
    Summary
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    A hiatal hernia often accompanies benign esophageal strictures. Lower esophageal strictures without a hiatal hernia may indicate malignancy, warranting further investigation.

    Area of Science:

    • Gastroenterology
    • Oncology
    • Radiology

    Background:

    • Peptic strictures and esophageal malignancy are common conditions.
    • Hiatal hernias are frequently associated with benign esophageal conditions.

    Purpose of the Study:

    • To investigate the association between hiatal hernias and lower esophageal strictures.
    • To differentiate between benign peptic strictures and esophageal malignancy based on hiatal hernia presence.

    Main Methods:

    • Retrospective analysis of 93 patients with benign peptic strictures.
    • Retrospective analysis of 73 patients with lower third esophageal malignancy.
    • Comparison of hiatal hernia prevalence in both groups.

    Main Results:

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  • 93% of benign strictures were associated with a hiatal hernia.
  • Only 4% of benign strictures occurred without a hiatal hernia.
  • The majority of esophageal malignancies were not associated with a hiatal hernia.

    • Conclusions:

    • The presence of a hiatal hernia strongly suggests a benign peptic stricture.
    • A lower esophageal stricture without a hiatal hernia increases suspicion for malignancy.
    • This finding provides a statistical basis for diagnostic considerations in esophageal strictures.