estenoses

Stenosis, or stenoses in the plural, is the abnormal narrowing of a hollow organ, duct, or vessel. It can be congenital or acquired and may affect any body system, often reducing the flow of blood, air, urine, bile, or contents within a lumen.

Common sites and underlying causes vary. In the vascular system, stenosis may occur in arteries such as the aorta, carotid, renal, or peripheral arteries and is frequently caused by atherosclerosis, fibrous scar formation after injury or surgery, or vasculitis. In the nervous system, spinal stenosis refers to narrowing of the spinal canal or foramina, often due to degenerative changes, disc herniation, or tumors. Nasal, esophageal, biliary, urethral, and intestinal stenoses may result from congenital malformations, inflammatory or autoimmune diseases, tumors, radiation, trauma, or postoperative scarring.

Clinical presentation depends on the site and degree of narrowing. Vascular stenosis can cause claudication, hypertension, ischemia, or transient ischemic events. Spinal stenosis may produce neurogenic or mechanical back pain with leg symptoms. Nasal stenosis presents with obstruction; esophageal stenosis causes dysphagia; urethral stenosis leads to decreased urine flow; biliary stenosis can cause jaundice and cholestasis.

Diagnosis relies on targeted imaging and endoscopy. Noninvasive approaches include duplex ultrasound, CT angiography, and MR angiography to assess luminal narrowing. Invasive angiography provides definitive visualization. Endoscopic evaluation may be necessary for luminal stenoses of the esophagus or biliary tract.

Treatment is tailored to the site and severity and may combine medical management of risk factors with interventional or surgical procedures. Options include endovascular angioplasty with or without stenting, surgical bypass or resection, endoscopic dilation, or decompression procedures for spinal stenosis. Prognosis varies with location, extent of disease, and the presence of comorbid conditions.