Pediatric eosinophilic esophagitis: radiologic findings with pathologic correlation.
BACKGROUND
Eosinophilic esophagitis is increasingly recognized as a cause of dysphagia or food impaction in pediatric patients. It has a high male predominance and is often associated with a history of allergy or asthma.


OBJECTIVE
To correlate fluoroscopic findings in eosinophilic esophagitis with the endoscopic and histologic findings.


METHODS
We retrospectively reviewed the upper gastrointestinal (UGI) findings of eosinophilic esophagitis and correlated them with the clinical, endoscopic and histologic findings in a series of 17 children (12 boys, 5 girls).


RESULTS
UGI findings were normal in 12 children, including 4 who had a normal UGI exam after endoscopic disimpaction for an obstructing food bolus. Five children had strictures identified on UGI: one was demonstrated with endoscopy. This suggests that the impactions and strictures were due to an esophageal dysmotility rather than a fixed anatomic abnormality.


CONCLUSIONS
Because the UGI findings are frequently normal in eosinophilic esophagitis, radiologists need to have a high index of suspicion for this disease. In children with a strong clinical history, especially impaction in the absence of an esophageal stricture, endoscopy and biopsy are indicated for further evaluation.
Binkovitz
Larry A
LA
Nationwide Children's Hospital, Columbus, OH, USA. binkovitz@yahoo.com
Lorenz
Emily A
EA
Di Lorenzo
Carlo
C
Kahwash
Samir
S
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004802:Eosinophilia / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D004941:Esophagitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D055815:Young Adult