Barrett's ulcer.
A case of an ulcer developing within previously documented Barrett's epithelium is reported. The patient had symptoms of gastroesophageal reflux for many years and Barrett's esophagus beginning 21 cm from the incisor teeth was documented by endoscopy one year earlier. Hospitalization was necessitated by an upper gastrointestinal bleed which was found to be due to an ulcer at 29 cm from the incisors. There was no inflammation of the surrounding columnar epithelium nor was there any esophagitis within the squamous epithelium. This case documents that ulcers in Barrett's esophagus can arise de novo within the columnar epithelium despite the hypothesis that this epithelium is present because it is more resistant to acid/peptic damage than squamous epithelium. This suggests that some ulcers in Barrett's epithelium may be due to spontaneous degeneration of the epithelium as this patient had no esophagitis, suggesting that gastroesophageal reflux was not causing diffuse damage.
Maiorana
A
A
University of Chicago, Department of Surgery and Pathology, Illinois 60637.
Stephens
J K
JK
Little
A G
AG
D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000209:etiology / Q000473:pathology*; D004848:Epithelium / Q000473:pathology; D004935:Esophageal Diseases / Q000473:pathology*; D004945:Esophagoscopy; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D014456:Ulcer / Q000209:etiology / Q000473:pathology