Open AccessEsophageal trachealization: A feature of eosinophilic esophagitis
Author(s) -
Abdulrahman AlHussaini,
Toufic Semaan,
I. A. El Hag
Publication year - 2009
Publication title -
the saudi journal of gastroenterology/saudi journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 32
eISSN - 1998-4049
pISSN - 1319-3767
DOI - 10.4103/1319-3767.54747
Subject(s) - eosinophilic esophagitis , medicine , dysphagia , esophagus , fluticasone , gastroenterology , discontinuation , esophagitis , endoscopy , reflux , surgery , disease , asthma
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.