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Ann Thorac Surg 1978;26:364-374
© 1978 The Society of Thoracic Surgeons

Articles

Monilial Esophagitis: An Increasingly Frequent Cause of Esophageal Stenosis?

Mark B. Orringer, M.D.*, Herbert Sloan, M.D.

Department of Surgery, Section of Thoracic Surgery, University of Michigan Medical School, Ann Arbor, MI.

* Address reprint requests to Dr. Orringer, C7079 University Hospital, Ann Arbor, MI 48109.

Acute monilial esophagitis generally responds well to oral nystatin therapy, and long-term sequelae of this condition have not been well recognized. Nor is it generally appreciated that Candida infections of the esophagus may occur in subacute or chronic form. Four men, 34, 40, 41, and 49 years old, have been treated for esophageal stenoses resulting from different types of chronic monilial esophageal involvement. All were seen with painless dysphagia and strictures of the upper half of the thoracic esophagus. In 2 patients, an associated roentgenographic pattern of "intramural esophageal pseudodiverticulosis" was present. Two patients have been treated successfully with esophageal dilation, 1 required substernal colonic bypass of the stenotic, perforated esophagus, and 1 is being evaluated for esophageal bypass. Esophageal moniliasis must be considered in the differential diagnosis of benign esophageal strictures, particularly those involving the upper half of the thoracic esophagus.




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