Peptic Stricture

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Relief of dysphagia after dilatation of peptic stricture is prolonged if a PPI maintenance is given. However if a patient doesn't achieve adequate dilatation after 5 sessions then the patient is said to have a refractory stricture which will require either triamcinolone injection or esophageal stenting. But before doing everything, prove that the stricture is benign by taking biopsy from it.

Peptic structure - is it having malignancy of dysplasia - both needs surgical intervention Biopsy need to be done to confirm absence of malignant or dysplasia For peptic stricture management - it is essentially because of acid and reflux - both need to be treated aggressively Esomeprazol 40 mg twice a day Itopride 50 mg thrice a day Domperidone 10 mg thrice a day Sucralfate syrup 1 gm four times a day This will help in reduction of symptoms and recurrence, gradually the recurrence time will get prolonged But he may keep on requiring multiple dilatation

It may be case of hypertrophic pyloric stenosis which is due hyoertrophy o f the muscularis propia of the pylorus. Tp suffers a lot due to delayed diagnosis. Oesophagogastroduodenoscopy reveals an unique sign called cervix sign characterised by smooth narrow border of pylorus. Three types of pyloris stenosis or stricture A infantile diagnosed late stage B. Due to underlying gastric pathology like DU, pyloric stenosis, malignancy stomal tumour C. Idiopathic hypertrophic pyloric stenosis Medicines PPI antispasmodic along with dilatation After imaging and biopsy if no patholhy is found and stamped as idiopathic pyloris stenosis surgery is preferable than any other procedure like dilatation. Distal gastrectomy with Bilroth 1 gastroduodenostomy.

Recurrent peptic ulcer... need to ruleout ZE syndrome... and malignancy. It requires surgical intervention

PEPTIC STRUCTURE.. NEED'S TO..FIND OUT UNDERLYING CAUSE..? GERD.. ? MALIGNANCY.. MEANWHILE TREAT WITH.. SY.. SUKRAFIL.. PANTAPRAZOLE..WITH.. ONDANCETRAN ..

Recurrent peptic stricture I presume oesophagealcardiac stricture needs to be released surgically Good oldays Rydiels surgical intervention

Thanx dr Asad Zaman Leemon
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Peptic stricture @ Key points: Have to find out what reason behind this. Tx should according to the cause.... Surgical procedure always preferable,primarily Traditional tx should be role out.

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