SSAT - Esophageal Ulcers At an Urban Emergency Hospital: a Twenty Year Experience

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Esophageal Ulcers At an Urban Emergency Hospital: a Twenty Year Experience
Terra R. Pearson^*, Charles E. Lucas, Choichi Sugawa
Surgery, Wayne State University, Detroit, MI

Objective: This study assessed the incidence, etiologies, endoscopic and pathologic findings, and clinical outcomes of patients with esophageal ulcers seen in an urban acute care hospital over twenty years.
Methods: This is a retrospective chart review of all upper endoscopies (EGD) performed by a single surgical endoscopist from January 1991 to December 2010. For all patients diagnosed with esophageal ulcer, a thorough review of the paper and electronic medical records was performed.
Results: Out of 13,891 EGDs performed during the study period, there were 262 patients (pts) with esophageal ulcers for an incidence of 1.88 %. The most common etiologies were gastroesophageal reflux disease (GERD; 59%), and drug induced (19.7 %). Other causes included herpes simplex virus (7 pts), ingestion of a caustic substance (6 pts), Candida (5 pts), foreign body (5 pts), AIDS-related (3 pts), post-gastrectomy (2 pts), and esophageal diverticulosis (1 pt). The most common presenting complaints were nausea and vomiting, epigastric pain, and hematemesis (48, 45, and 35%, respectively). There were 12 deaths; most (11 pts) were due to comorbid diseases, whereas one death was a direct result of esophageal perforation.
Conclusions: Esophageal ulcer is a rare cause of upper gastrointestinal problems. Most are caused by GERD or drugs; the most common drugs are aspirin and ibuprofen. Mortality (4.6%) is due to comorbid disease, whereas perforation led to one death (0.4%).

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