Yetişkin hastalarda Schatzki halkası: 3. basamak merkezi deneyimi

Yıl 2018, , 46 - 49, 25.09.2018

Mustafa Kaplan , Volkan Gökbulut , Orhan Coşkun , Adem Aksoy Erkin Öztaş , Ertuğrul Kayaçetin

https://doi.org/10.17940/endoskopi.460108

Öz

Giriş
ve Amaç: Shatzki halkası özofagus alt kısmında lümeni halka
veya yüzük şeklinde daraltan yapılardır. Bu çalışmada Shatzki halkasının endoskopik
bulgular ve diğer hastalıklar ile ilişkisini araştırmayı amaçladık. Gereç ve Yöntem: Bu çalışma Ocak
2014-Aralık 2015 tarihleri arasında endoskopi yapılan hastaların kayıtları
incelenerek retrospektif olarak yapılmıştır. Toplamda 5.000 endoskopi kaydı
incelenmiş ve Shatzki halkası tespit edilen 104 hasta çalışmaya dahil
edilmiştir.  Bulgular: Araştırma popülasyonu 46 kadın (%44,2) ve 58 erkek (%55,8)  erkek hasta olmak üzere 104 kişiden oluştu.
Hastaların ortalama yaşı 60,8±14,1 yıldı. Hastaların en sık başvuru
endikasyonları disfaji (%26), dispepsi (%38,5) ve karın ağrısı (%28,8) idi.
Endoskopi bulguları incelendiğinde hastaların %53,8’inde reflü özofajit,
%50’sinde hiatal herni tespit edildi. Özofageal divertikül %4,8, başka web %1,
özofageal ülser %5.7, özofageal polip %0,9, özofagus varisleri %1,9, özofagus
motilite bozuklukluğu (hipertrofik alt özofagus sfinkteri) %1,9 ve Barrett
özofagus %3,8 hastada tespit edildi. Hastaların %58’inde Helicobacter pylori, %19’unda demir eksikliği anemisi ve  %5,7’sinde vitamin B12 eksikliği saptandı. Sonuç:
Shatzki
halkası aralıklı disfajinin önemli sebeplerinden biri olup reflü özofajit,
hiatal herni ve demir eksikliği anemisi ile birliktelik göstermektedir.

Anahtar Kelimeler

Özofageal web, reflü özofajit, hiatal herni, demir eksikliği anemisi, disfaji

Schatzki ring in adult patients: Experience of a tertiary-stage center

Öz

Background and aim: The Schatzki ring is a ring-shaped luminal
constriction in the lower part of the esophagus. In this study, we aimed to
investigate the relationship of the Schatzki ring with endoscopic findings and other
diseases. Material and Methods: This
study was retrospectively conducted by examining the records of patients who
underwent endoscopy between January 2014 and December 2015. A total of 5.000
endoscopic recordings were examined, and 104 patients with Schatzki ring were included in the study. Results: The study population consisted
of 104 patients, 46 (44.2%)
female and 58 (55.8%)
male. The mean patient age was 60.8±14.1 years. The most frequent admission indications were dysphagia
(26%), dyspepsia (38.5%), and abdominal pain (28.8%). When endoscopic findings were examined,
53.8% of patients had reflux esophagitis and 50% had hiatal hernia. Esophageal diverticulum was
present in 4.8%; other esophageal web, in 1%; esophageal ulcer, in 5.7%; esophageal polyp, in 0.9%; esophageal varices, in 1.9%; esophagus motility disorder
(hypertrophic lower esophageal sphincter), in 1.9%; and Barret’s esophagus, in 3.8%. Helicobacter
pylori was diagnosed in 58% of patients; iron deficiency anemia, in 19%; and B12 deficiency, in 5.7%.  Conclusion:
The Schatzki ring is one of the important causes of
intermittent dysphagia and is associated with reflux esophagitis, hiatal
hernia, and iron deficiency anemia.

Anahtar Kelimeler

Esophageal web, reflux esophagitis, hiatal hernia, iron deficiency anemia, dysphagia

Kaynakça

• 1- Schatzki R.The lower esophageal ring. Long term follow-up of symptomatic and asymptomatic rings. Am J Roentgenol Radium Ther Nucl Med 1963;90:805-10.
• 2-Akın M. Schatzki's ring (Lower esophageal mucosal ring). Turkiye Klinikleri J Gen Surg-Special Topics 2012;5:116-20.
• 3- Mitre MC, Katzka DA, Brensinger CM, et al. Schatzki ring and Barrett's esophagus: do they occur together? Dig Dis Sci 2004;49:770-3.
• 4- Chen YM, Gelfand DW, Ott DJ, Munitz HA. Natural progression of the lower esophageal mucosal ring. Gastrointest Radiol 1987;12:93-8.
• 5- Müller M, Gockel I, Hedwig P, et al. Is the Schatzki ring a unique esophageal entity? World J Gastroenterol 2011;17:2838-43.
• 6- Nurko S, Teitelbaum JE, Husain K, et al. Association of Schatzki ring with eosinophilic esophagitis in children. J Pediatr Gastroenterol Nutr 2004;38:436-41.
• 7- Müller M, Eckardt AJ, Fisseler-Eckhoff A, et al. Endoscopic findings in patients with Schatzki rings: evidence for an association with eosinophilic esophagitis. World J Gastroenterol 2012;18:6960-6.
• 8- Wright RA, Hurwitz AL. Relationship of hiatal hernia to endoscopically proved reflux esophagitis. Dig Dis Sci 1979;24:311-3.
• 9- Armstrong D, Bennett JR, Blum AL, et al. The endoscopic assessment of esophagits: a progress report on observer agreement. Gastroenterology 1996;111:85-92.
• 10- Towbin AJ, Diniz LO. Schatzki ring in pediatric and young adult patients. Pediatr Radiol 2012;42:1437-40.
• 11- Schatzki ring as a symptom of gastroesophageal reflux disease. Levin MD, Mendel'son G. Vestn Rentgenol Radiol 2015;1:5-15.
• 12- Ott DJ, Ledbetter MS, Chen MY, et al. Correlation of lower esophageal mucosal ring and 24-h pH monitoring of the esophagus. Am J Gastroenterol 1996;91:61-4.
• 13- Wills JC, Hilden K, Disario JA, Fang JC. A randomized, prospective trial of electrosurgical incision followed by rabeprazole versus bougie dilation followed by rabeprazole of symptomatic esophageal (Schatzki’s) rings. Gastrointest Endosc 2008;67:808-13.
• 14- Sgouros SN, Vlachogiannakos J, Karamanolis G, et al. Long-term acid suppressive therapy may prevent the relapse of lower esophageal (Schatzki’s) rings: a prospective, randomized, placebo-controlled study. Am J Gastroenterol 2005;100:1929-34.
• 15- Ozaydin N, Turkyilmaz SA, Cali S. Prevalence and risk factors of Helicobacter pylori in Turkey: a nationally-representative, cross-sectional, screening with the 13C-Urea breath test. BMC Public Health 2013;13:1215.
• 16- Güngör G, Odabaş Y, Dabak R, et al. Schatzki halkası ile birlikte olan Plummer-Vinson sendromu: Bir olgu sunumu. Akademik Gastroenteroloji Dergisi 2008;7:56-8.