Oesophagitis dissecans superficialis complicating repeated rigid oesophagoscopy and dilatation

Abstract

Oesophagitis dissecans superficialis is an extremely rare and benign condition where the mucosal epithelium of the oesophagus sloughs off along the whole length of the oesophagus and is expelled as an oesophageal cast. This condition has been reported in association with various aetiological factors. We report a case of an oesophageal cast in a patient who underwent repeated oesophagoscopy and dilatation for a postcricoid web. We discuss the possible relationship between trauma to the upper oesophagus and the development of oesophagitis dissecans superficialis.

Sloughing esophagitis is associated with chronic debilitation and medications that injure the esophageal mucosa

“…13,17 A wide age range with equal sex distribution is reported in the literature, and cases have been reported in healthy young adults, who often present with dysphagia or odynophagia or who rarely may vomit a membranous cast. [13][14][15][16][17][18][19][20][21] Therefore, esophagitis dissecans superficialis shares with sloughing esophagitis the facts that both of them are intraepithelial abnormalities, both may be drug-related, and both may have endoscopic membranes. However, esophagitis dissecans superficialis seems, in some cases, to have associations that are not observed in sloughing esophagitis, and often has different histologic patterns and different clinical presentations.…”

Identification of Esophagitis Dissecans Superficialis by Endoscopy

“…1,3,5 No specific therapy is recommended for treating EDS, and the clinical course is driven by the patient's underlying disease (possibly self-limited). There are no published data to guide follow-up.…”

Oesophagitis dissecans superficialis: role of oesophageal biopsies in early diagnosis

“…On gastroscopy, he did have oesophageal strictures which have been reported in the literature as a common finding in patients with ODS and perhaps sequelae of the disease 6 . However, ODS has also been linked to repeated mechanical oesophageal trauma, such as repeated balloon dilatation of oesophageal strictures 7 …”

“…6 However, ODS has also been linked to repeated mechanical oesophageal trauma, such as repeated balloon dilatation of oesophageal strictures. 7 ODS is usually diagnosed by taking a biopsy during gastroscopy (Figs 1,2). 5 Furthermore, macroscopic features of ODS seen in this patient resembling candidiasis have only been reported once in the literature previously (Fig.…”