Esophageal Trachealization: A Feature of Eosinophilic Esophagitis |
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Authors: | Abdulrahman A Al-Hussaini Toufic Semaan and Imad A El Hag |
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Institution: | 1Department of Medicine, Children''s Hospital, King Fahad Medical City, King Saud Medical Complex, Riyadh, Saudi Arabia;2Department of Pathology, Children''s Hospital, King Fahad Medical City, King Saud Medical Complex, Riyadh, Saudi Arabia |
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Abstract: | 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. |
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Keywords: | Eosinophilic esophagitis esophageal rings fluticasone |
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