esôfago de Barrett
Резюме
Определение
Esôfago de Barrett é uma alteração no epitélio escamoso normal do esôfago para metaplasia intestinal especializada.[1] Isso está associado ao refluxo gastroesofágico, mesmo que o refluxo seja assintomático.[2][3] A histologia mostrando epitélio com revestimento colunar é essencial para o diagnóstico, com ou sem metaplasia intestinal e com células caliciformes.[4] Além dos sintomas relacionados ao refluxo gastroesofágico, a principal preocupação é o aumento do risco de adenocarcinoma do esôfago.[2][3][Figure caption and citation for the preceding image starts]: Esôfago de Barrett; mucosa cor de salmão estendendo-se acima da junção gastroesofágica como uma coluna contínuaDa coleção pessoal do Dr. Vic Velanovich; usado com permissão [Citation ends].
[Figure caption and citation for the preceding image starts]: Esôfago de Barrett; mucosa cor de salmão estendendo-se acima da junção gastroesofágica com uma borda acentuada irregularDa coleção pessoal do Dr. Vic Velanovich; usado com permissão [Citation ends].
[Figure caption and citation for the preceding image starts]: Metaplasia de Barrett sem displasia, mostrando o epitélio colunar com células caliciformes da região superior à junção gastroesofágicaCortesia de Adrian Ormsby, MD, Henry Ford Hospital, Detroit, MI [Citation ends].
[Figure caption and citation for the preceding image starts]: Metaplasia de Barrett com displasia de baixo grau; células e núcleos mais irregularesCortesia de Adrian Ormsby, MD, Henry Ford Hospital, Detroit, MI [Citation ends].
[Figure caption and citation for the preceding image starts]: Metaplasia de Barrett com displasia de alto grau; irregularidade mais avançada das célulasCortesia de Adrian Ormsby, MD, Henry Ford Hospital, Detroit, MI [Citation ends].
[Figure caption and citation for the preceding image starts]: Metaplasia de Barrett com displasia de alto grau associada a um foco de carcinoma intramucoso; células francamente malignas além da extensão da membrana basal envolvendo a lâmina própriaCortesia de Adrian Ormsby, MD, Henry Ford Hospital, Detroit, MI [Citation ends].
Анамнез и осмотр
Ключевые диагностические факторы
- presença de fatores de risco
- pirose
- regurgitação
- disfagia
Другие диагностические факторы
- achado incidental durante uma endoscopia digestiva por outra indicação
- dor torácica
- laringite
- tosse
- dispneia ou sibilância
- história de pneumonia por aspiração
Факторы риска
- refluxo de ácido-bile ou DRGE
- envelhecimento
- etnia branca
- sexo masculino
- história familiar de esôfago de Barrett ou adenocarcinoma esofágico
- obesidade
- tabagismo
Диагностические исследования
Исследования, которые показаны в первую очередь
- endoscopia digestiva alta com biópsia
- esofagograma com bário
Неотложные исследования
- cromoendoscopia
- imagem por autofluorescência
- endomicroscopia confocal a laser
- tomografia de coerência óptica
- espectroscopia
- endoscopia transnasal
- endoscopia por cápsula
- esponja revestida com gelatina
Алгоритм лечения
esôfago de Barrett não displásico
displasia de baixo grau
displasia de alto grau
Составители
Авторы
Andres F. Carrion, MD
Associate Professor of Medicine
Division of Gastroenterology and Hepatology
University of Miami
Miller School of Medicine
Miami
FL
Раскрытие информации
AFC is a scientific advisor for Intercept Pharmaceuticals and Gilead Sciences, and is on the speaker bureau for Bristol-Myers Squibb, Intercept Pharmaceuticals, Merck, and Alexion.
Ricardo Badillo, MD
Assistant Professor of Medicine
Division of Gastroenterology
Texas Tech University Health Sciences Center
El Paso
TX
Раскрытие информации
RB declares that he has no competing interests.
Marc J. Zuckerman, MD
Professor of Medicine
Chief
Division of Gastroenterology
Texas Tech University Health Sciences Center
El Paso
TX
Раскрытие информации
MJZ is on the speakers bureau for Phathom Pharmaceuticals.
Выражение благодарностей
Dr Andres F. Carrion, Dr Ricardo Badillo and Dr Marc J. Zuckerman would like to gratefully acknowledge Dr Vic Velanovich, the previous contributor to this topic.
Раскрытие информации
VV is an author of a number of references cited in this topic.
Рецензенты
Richard E. Sampliner, MD
Professor
Medicine Chief
Department of Gastroenterology
University of Arizona College of Medicine
Tucson
AZ
Раскрытие информации
RES declares that he has no competing interests.
Peter McCulloch, MBChB, MA, MD, FRCS (Ed), FRCS (Glas)
Clinical Reader in Surgery
Nuffield Department of Surgery
University of Oxford
Oxford
UK
Раскрытие информации
PM declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
Fitzgerald RC, di Pietro M, Ragunath K, et al. British Society of Gastroenterology guidelines on the diagnosis and management of Barrett's oesophagus. Gut. 2014 Jan;63(1):7-42.Полный текст Аннотация
Shaheen NJ, Falk GW, Iyer PG, et al. Diagnosis and management of Barrett's esophagus: an updated ACG guideline. Am J Gastroenterol. 2022 Apr 1;117(4):559-87.Полный текст Аннотация
Fitzgerald RC. Molecular basis of Barrett's oesophagus and oesophageal adenocarcinoma. Gut. 2006 Dec;55(12):1810-20. Аннотация
Weusten B, Bisschops R, Coron E, et al. Endoscopic management of Barrett's esophagus: European Society of Gastrointestinal Endoscopy (ESGE) position statement. Endoscopy. 2017 Feb;49(2):191-8.Полный текст Аннотация
Sharma P, Dent J, Armstrong D, et al. The development and validation of an endoscopic grading system for Barrett's esophagus: the Prague C & M criteria. Gastroenterology. 2006 Nov;131(5):1392-9.Полный текст Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Esofagite
- Doença do refluxo gastroesofágico (DRGE)
- Adenocarcinoma esofágico
Больше ОтличияРекомендации
- Endoscopic eradication therapy of Barrett’s esophagus and related neoplasia
- Adverse events associated with EGD and EGD-related techniques
Больше РекомендацииЛифлеты для пациента
Refluxo gastroesofágico, pirose e doença do refluxo gastroesofágico (DRGE)
Faringite
Больше Лифлеты для пациента
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