Chronic globus sensation due to inlet patch – new endoscopic treatment
A 52-year-old woman, AL, was
referred by her GP to ENT surgeons
with a history of sore throat and
globus sensation for over a year.
She underwent full ENT diagnostic
workup and no cause was
found, though note was made
of laryngeal oedema consistent
with acid irritation of the larynx.
Gastroenterology opinion to assess
for Gastro-Oesophageal Reflux
Disease (GORD) was advised.
She subsequently underwent a
gastroscopy which revealed a
large inlet patch, the size of a
50p coin, at the very top of the
oesophagus and was referred to
Dr Dunn for further evaluation.
The inlet patch was characterised
using Narrow Band Imaging, an
optical enhancement technique.
The lesion was then treated with
RFA using a Through-The-Scope
(TTS) device which causes minimal
irritation during the procedure.
This was undertaken as a day
case under conscious sedation.
Inlet patch proximal oesophagus x2
BarrX TTS RFA device
Dr Jason Dunn is a Consultant
Gastroenterologist at Guy’s and
St Thomas’ NHS Foundation Trust
Hospital. His special interest in
Barrett’s Oesophagus followed
a CRUK clinical fellowship at
UCL, where he studied the use of
optical diagnostics and minimally
invasive endoscopic therapies. His
work on the treatment of Barrett’s
Oesophagus with RFA, and the use
of biomarkers to predict cancer
progression, has won prizes and
been published in high impact
Dr Dunn is proficient in EMR
and RFA, and teaches these
techniques internationally. He is
the Early Diagnosis Lead for the
London Cancer Alliance (LCA)
and has written guidelines for
the management of Barrett’s
Oesophagus for the LCA. He
currently holds Honorary Senior
Lecturer posts at King’s College
London and Oslo University in the
Institute of Medical Informatics,
and continues to be involved in
research into novel endoscopic
treatment of GI conditions.
After two months, a further session
of treatment was undertaken, but
already AL had noted a significant
improvement in symptoms. At the
second treatment, a tiny focus of inlet
patch remained that was treated, and
subsequently AL is symptom-free. Six
months after referral, the patient has
no residual visible inlet patch.
Pre and post RFA i) Inlet patch at 8
o’clock position ii) Immediately after
first ablation iii) Complete resolution
three months after first ablation.
For more information on inlet patch and radiofrequency ablation, or to make an appointment,
or contact Nicole Merrall at[email protected] ,
020 7403 3814