Paediatric eosinophilic oesophagitis presenting to the otolaryngologist.
BACKGROUND
The prevalence of eosinophilic oesophagitis is increasing. A Pubmed search for 'eosinophilic oesophagitis' and 'eosinophilic esophagitis' yielded 345 publications since 1976. Only seven were in otolaryngology journals.1-7 Patients typically present with dysphagia, vomiting, dyspepsia or food impaction and are therefore usually referred to a paediatric gastroenterologist; otolaryngologists are not usually involved in management. A missed diagnosis may result in oesophageal stricture.


METHODS
Two patients, aged two and four years, were referred to the paediatric otolaryngology department with intermittent upper oesophageal food impaction. A paediatric gastroenterologist was involved in the investigation. Histological examination of oesophageal biopsies demonstrated changes consistent with eosinophilic oesophagitis.


RESULTS
Both patients were expediently diagnosed, investigated and managed.


CONCLUSIONS
A diagnosis of eosinophilic oesophagitis must be considered in patients presenting with food bolus impaction. Early involvement of a paediatric gastroenterology team in the diagnosis is recommended in children presenting with oesophageal symptoms, in order to avoid delayed diagnosis.
Harris
R
R
Department of Otolaryngology, St George's Hospital, London, UK. bertieharris@yahoo.com
Mitton
S
S
Chong
S
S
Daya
H
H
D001706:Biopsy; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000209:etiology; D004802:Eosinophilia / Q000175:diagnosis*; D004941:Esophagitis / Q000175:diagnosis*; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology; D006801:Humans; D008297:Male; D016896:Treatment Outcome