Esophageal stricture

Esophageal strictures refer to any persistent intrinsic narrowing of the esophagus

The most common causes are fibrosis induced by inflammatory and neoplastic processes. Because radiographic findings are not reliable in differentiating benign from malignant strictures, all should be evaluated endoscopically. 

These most commonly result from:

These are typically caused by gastro-esophageal reflux disease (GERD), either as a separate entity or in the setting of:

Esophageal strictures are often associated with a hiatal hernia.

Benign strictures characteristically:

  • smoothly tapering
  • typically concentric narrowing, but may affect only one side of the esophagus (asymmetric wall rigidity)

Malignant strictures are characteristically:

  • abrupt
  • asymmetric
  • eccentric with irregular, nodular mucosa

Tapered margins may occur with malignant lesions because of the ease of submucosal spread of a tumor.

The risk of Barrett esophagus in a stricture is 20-40% and strictures should be evaluated endoscopically. 

Benign esophageal strictures are typically treated with dilation, providing symptomatic relief, however recurrent strictures do occur. Complex strictures (length >2 cm, tortuous) are more likely to be recurrent. Treatment of malignant strictures involves treating the underlying cause. In palliative strictures, stent placement and brachytherapy play a role 4.

Oesophageal pathology
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Article information

rID: 1767
Synonyms or Alternate Spellings:
  • Esophageal stricture
  • Oesophageal strictures
  • Esophageal strictures
  • Peptic stricture
  • Peptic strictures

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Cases and figures

  • Case 1: post corrosive stricture
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  • Case 2: malignant (proximal) & peptic (distal)
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  • Case 3: peptic stricture
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  • Case 4: secondary to correction atresia
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  • Case 5: Ringlike peptic stricture
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  • Case 6: peptic stricture with hiatus hernia
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