Esophagitis other imaging findings: Difference between revisions

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m (Anthony Gallo moved page Esophagitis endoscopy or ultrasound to Esophagitis other imaging findings: Renamed/Appropriate Microchapter)
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Image:Caustic lye esophagitis 1.jpg|Caustic lye esophagitis
Image:Caustic lye esophagitis 1.jpg|Caustic lye esophagitis
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===Reflux esophagitis===
* The [[endoscope]] has been before one of the [[diagnostic]] tools for GERD.
* Endoscopy is not recommended now for the diagnosis of GERD with the typical symptoms, however, it is used in [[screening]] for the GERD complications as [[esophagitis]], [[esophageal]] [[strictures]], and [[barrett's esophagus]].<ref name="KatzGerson2013">{{cite journal|last1=Katz|first1=Philip O|last2=Gerson|first2=Lauren B|last3=Vela|first3=Marcelo F|title=Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease|journal=The American Journal of Gastroenterology|volume=108|issue=3|year=2013|pages=308–328|issn=0002-9270|doi=10.1038/ajg.2012.444}}</ref>
* [[Endoscopy]] is also beneficial in doing [[biopsies]] in the [[screening]] of [[barrett's esophagus]].
===Eosinophilic esophagitis===
*[[Mucosal]] [[biopsies]] of the [[esophagus]] should be obtained in all patients in whom EoE is a clinical possibility regardless of the [[Endoscopy|endoscopic]] appearance.
*[[Endoscopic]] [[abnormalities]] in patients with EoE are as follows:<ref name="urlTable 3: Proposed classification and grading system for the endoscopic assessment of the esophageal features of eosinophilic esophagitis (<a id=ref-link-section-1 title= href=/articles/#ref44">44</a>)">{{cite web |url=https://www.nature.com/articles/ajg201371/tables/3 |title=Table 3: Proposed classification and grading system for the endoscopic assessment of the esophageal features of eosinophilic esophagitis (<a id=ref-link-section-1 title="" href=/articles/#ref44>44</a>) |format= |work= |accessdate=}}</ref><ref name="urlVertical lines in distal esophageal mucosa (VLEM): a true endoscopic manifestation of esophagitis in children? - PubMed - NCBI">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmed/9199905?dopt=Abstract&holding=npg |title=Vertical lines in distal esophageal mucosa (VLEM): a true endoscopic manifestation of esophagitis in children? - PubMed - NCBI |format= |work= |accessdate=}}</ref><ref name="urlFragility of the esophageal mucosa: a pathognomonic endoscopic sign of primary eosinophilic esophagitis? - PubMed - NCBI">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmed/12612531?dopt=Abstract&holding=npg |title=Fragility of the esophageal mucosa: a pathognomonic endoscopic sign of primary eosinophilic esophagitis? - PubMed - NCBI |format= |work= |accessdate=}}</ref><ref name="urlEosinophilic esophagitis: red on microscopy, white on endoscopy. - PubMed - NCBI">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmed/15383737?dopt=Abstract&holding=npg |title=Eosinophilic esophagitis: red on microscopy, white on endoscopy. - PubMed - NCBI |format= |work= |accessdate=}}</ref><ref name="urlThe prevalence and diagnostic utility of endoscopic features of eosinophilic esophagitis: a meta-analysis. - PubMed - NCBI">{{cite web |url=https://www.ncbi.nlm.nih.gov/pubmed/22610003?dopt=Abstract&holding=npg |title=The prevalence and diagnostic utility of endoscopic features of eosinophilic esophagitis: a meta-analysis. - PubMed - NCBI |format= |work= |accessdate=}}</ref>
**Fixed [[esophageal]] ring which is corrugated
**White [[exudate]]
**Longitudinal furrows
**[[Mucous membrane|Mucosal]] [[pallor]]
**[[Diffuse]] [[esophageal]] narrowing
**[[Mucosal]] fragility leading to [[esophageal]] lacerations during the [[endoscopy]]
*However, because these [[Endoscopy|endoscopic]] features have been described in other [[esophageal]] [[disorders]], none can be considered [[pathognomonic]] for EoE.
<gallery>
File:Eosinophilic esophagitis endo.jpg|Endoscopy of the esophagus: Eosinophilic esophagitis <br> Source: Wikimedia
</gallery>
===Biopsy in EoE===
*Characteristic features are as follows:
**> 20 eosinophils/0.24 mm2.
**[[Papillae]] are elongated
**[[Papillae]] reach into the top 1/3 of the epithelial layer
**Basal cell hyperplasia; > 3 cells thick or >15% of epithelial thickness
[[Image:Eosinophilic esophagiits path.jpg|thumb|center|150px|[[H&E]] stain of [[esophagus]] [[biopsy]] showing eosinophilic esophagitis, manifested by an infiltration of [[eosinophils]] in the [[lamina propria]]]]


==References==
==References==

Revision as of 17:02, 20 January 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Endoscopy or Ultrasound

Endoscopic Findings

Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

Removal of a piece of tissue from the esophagus for further examination (biopsy)

  • Candida esophagitis

    Candida esophagitis

  • NSAID esophagitis

    NSAID esophagitis

  • Peptic esophagitis

    Peptic esophagitis

  • Herpetic esophagitis

    Herpetic esophagitis

  • Caustic lye esophagitis

    Caustic lye esophagitis

Reflux esophagitis

Eosinophilic esophagitis

  • Endoscopy of the esophagus: Eosinophilic esophagitis Source: Wikimedia

    Endoscopy of the esophagus: Eosinophilic esophagitis
    Source: Wikimedia

Biopsy in EoE

  • Characteristic features are as follows:
    • > 20 eosinophils/0.24 mm2.
    • Papillae are elongated
    • Papillae reach into the top 1/3 of the epithelial layer
    • Basal cell hyperplasia; > 3 cells thick or >15% of epithelial thickness
H&E stain of esophagus biopsy showing eosinophilic esophagitis, manifested by an infiltration of eosinophils in the lamina propria

References

  1. ↑ Katz, Philip O; Gerson, Lauren B; Vela, Marcelo F (2013). "Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease". The American Journal of Gastroenterology. 108 (3): 308–328. doi:10.1038/ajg.2012.444. ISSN 0002-9270.
  2. ↑ "Vertical lines in distal esophageal mucosa (VLEM): a true endoscopic manifestation of esophagitis in children? - PubMed - NCBI".
  3. ↑ "Fragility of the esophageal mucosa: a pathognomonic endoscopic sign of primary eosinophilic esophagitis? - PubMed - NCBI".
  4. ↑ "Eosinophilic esophagitis: red on microscopy, white on endoscopy. - PubMed - NCBI".
  5. ↑ "The prevalence and diagnostic utility of endoscopic features of eosinophilic esophagitis: a meta-analysis. - PubMed - NCBI".


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