title: Contribution of Esophagram to the Evaluation of Complicated Pediatric Eosinophilic Esophagitis.
abstract: OBJECTIVE
  In contrast to peptic strictures, clinically significant strictures in patients with eosinophilic esophagitis (EoE) may be subtle and go unrecognized at the time of endoscopy. We aimed to identify how often stricture was identified by endoscopy as compared with contrast esophagram.
  
  
  METHODS
  We retrospectively reviewed esophagram and endoscopy examinations of all of the patients with EoE with esophageal stricture seen at a tertiary care pediatric hospital over a 6-year period who had both procedures completed within a 3-month time frame. Medical charts were reviewed for clinicopathologic information including age, duration of symptoms, histology, and treatment.
  
  
  RESULTS
  Twenty-two children with EoE-associated stricture completed both esophagram and endoscopic assessments. Esophageal strictures were identified by esophagram, and not endoscopy, in 55% of these children. Patients with stricture identified at esophagram alone had a shorter duration of symptoms (2.1 years duration vs 5.4 years duration, P = 0.03) than the group identified by endoscopy. Preoperative radiographic identification of a stricture was associated with dilation more often being performed.
  
  
  CONCLUSIONS
  Esophagram is a valuable test to assess esophageal anatomy in children with complicated EoE. Esophagram may be able to detect subtle fibrostenosis earlier in the natural history of the disease than endoscopy.
authors.affiliation: *Digestive Health Institute, Gastrointestinal Eosinophilic Diseases Program, Children's Hospital Colorado, Gastrointestinal Eosinophilic Diseases Program, Department of Pediatrics †Department of Radiology, Children's Hospital Colorado, Aurora.
authors.forename: Calies
authors.initials: C
authors.lastname: Menard-Katcher
authors.forename: Mathew P
authors.initials: MP
authors.lastname: Swerdlow
authors.forename: Pooja
authors.initials: P
authors.lastname: Mehta
authors.forename: Glenn T
authors.initials: GT
authors.lastname: Furuta
authors.forename: Laura Z
authors.initials: LZ
authors.lastname: Fenton
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology; D003938:Diagnostic Techniques, Digestive System; D057765:Eosinophilic Esophagitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D004804:Eosinophils / Q000473:pathology*; D004940:Esophageal Stenosis / Q000000981:diagnostic imaging*; D004945:Esophagoscopy; D004947:Esophagus / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D055815:Young Adult