Esophageal trachealization: a feature of eosinophilic esophagitis.
Eosinophilic esophagitis (EE) is an inflammatory condition characterized by intense eosinophilic infiltration of the esophagus. EE is frequently misdiagnosed as gastroesophageal reflux disease. Here, we present a child with EE and a characteristic endoscopic finding, "ringed esophagus". An 11-year-old Saudi boy presented with dysphagia for 1 year. He had experienced an intermittent sensation of solid food sticking in his chest, which was relieved by drinking liquids. A barium swallow excluded anatomical causes of dysphagia, but revealed multiple-ringed esophagus. Endoscopy showed a furrowing and trachealizing appearance of the entire esophagus. Hisologically, extensive eosinophilic infiltration was a feature in biopsies obtained from the esophagus. The child responded well to a 2-month course of inhaled fluticasone. Symptoms recurred 3 months after discontinuation of therapy, which necessitated resumption of inhaled fluticasone. The endoscopic appearance of multiple esophageal rings should raise suspicion of EE and be confirmed by esophageal biopsies.
Al-Hussaini
Abdulrahman A
AA
Department of Medicine, Children's Hospital, King Fahad Medical City, King Saud Medical Complex, Riyadh - 11525, abia. aa_alhussaini@yahoo.com
Semaan
Toufic
T
El Hag
Imad A
IA
D001706:Biopsy; D002648:Child; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D004802:Eosinophilia / Q000175:diagnosis*; D004941:Esophagitis / Q000175:diagnosis*; D006801:Humans; D008297:Male