Esophageal ulcer

Esophageal ulcer is an ulceration of the mucous membrane of the esophagus. The disease was first described by Quincke in 1879 and is more common in men than in women. Ulcers are localized mainly in the lower third of the esophagus.

Etiology and pathogenesis

A distinction is made between true (peptic) and symptomatic ulcers of the esophagus.

True esophageal ulcers are peptic ulcers that occur in individuals with esophageal hiatus hernia, cardiac insufficiency, and gastroesophageal reflux disease.

Causes of Esophageal Ulcers

Clinical picture

1. Retrosternal pain is the most important symptom of an esophageal ulcer. As a rule, it occurs during meals. If the ulcer is located directly in the cardia or subcardia, the pain is felt high in the epigastrium or in the area of the xiphoid process.
2. Dysphagia is a sensation of difficulty in the passage of food through the esophagus, caused by inflammatory edema of the mucous membrane of the esophagus and its dyskinesia. In some cases, dysphagia is caused by the development of ulcerative stenosis of the esophagus; in this case, regurgitation of esophageal contents is added.

Esophageal Ulcer Symptoms

Instrumental data

Esophagoscopy

V. M. Nechaev (1997) describes three forms of esophageal ulcers.

1. A focal ulcer is a small ulceration (0.3-1 cm in diameter) with clear, smooth, non-raised edges. Peristalsis is preserved, and there is no rigidity of the walls.
2. Deep ulcer - larger in size (0.5-3 cm in diameter) with clear, even edges rising above the surrounding tissue, peristalsis is preserved.
3. Flat-infiltrative ulcer - in the form of a flat infiltrate with a diameter of 0.3-3 cm with clear boundaries, hyperemic edges, covered with fibrin.

Diagnosis of esophageal ulcer