Contribution of Upper Digestive Endoscopy to the Management of Dysphagia at the Digestive Endoscopy Center of Idrissa Pouye General Hospital, Dakar: About 300 Cases

Abstract

Introduction: Dysphagia is an alarming symptom that requires upper gastrointestinal endoscopy to determine its etiology. The aim of this study was to assess the diagnostic and therapeutic value of upper digestive endoscopy (EGD) in patients presenting with dysphagia in Senegal. Methods : A retrospective descriptive study was conducted from January 2017 to December 2021 at the digestive endoscopy unit of Idrissa Pouye General Hospital (HOGIP). Included patients were those whose indication for endoscopy was dysphagia. Incomplete records and ENT-related causes were excluded. Results: A total of 300 patients were included. The prevalence of dysphagia was 6.8%. The average age was 44 years, ranging from 1 to 88 years. The sex ratio was 0.5. Dysphagia was classified as oropharyngeal in 63.5% of cases, organic in 91.8%, and chronic in 73.6%. Endoscopy was normal in 42% of patients; among those with biopsies, findings included HPV esophagitis (33.3%), eosinophilic esophagitis (11.1%), non-specific esophagitis (7.4%), and normal histology (48.1%). The most common endoscopic abnormalities were esophageal rings (22%), suspicious malignant lesions (13.7%), candidiasis (10%), and peptic lesions (5.3%). Regarding the esophageal rings, 80.3% were related to Plummer-Vinson syndrome (PVS) and 20.8% were Schatzki rings. For malignant-looking tumor lesions, squamous cell carcinoma was found in 63% of patients and adenocarcinoma in 18.5%. Bougie dilation was performed in 20.3% of patients. Conclusion: EGD is an essential tool in the evaluation of dysphagia. At the digestive endoscopy center of HOGIP Hospital in Dakar, the main etiologies identified were esophageal rings related to Plummer-Vinson syndrome and malignant tumors. Treatment mainly consisted of bougie dilation.