Radiographic abnormalities in eosinophilic esophagitis

Abstract

Eosinophilic gastroenteritis is an unusual condition of unknown cause in which there is eosinophilic infiltration of the gastrointestinal tract usually accompanied by a peripheral eosinophilia. Rarely, it can also involve the esophagus. Recently, the authors have encountered 3 cases of eosinophilic infiltration of the esophagus. All patients had a strong history of allergies. Two of our patients have had upper esophageal strictures, as have 2 other previously reported cases. This appears to be the most common manifestation. One patient had polypoid lesions of the esophagus as well as of the rest of the gastrointestinal tract. Motility disturbances may also be present. Although steroid treatment may be beneficial, the esophageal strictures usually require mechanical dilatation to relieve submucosal fibrosis. This entity should be considered in any patient who has an esophageal disorder in the presence of either a strong history of allergy or peripheral eosinophilia.

Fluoroscopic findings in pediatric eosinophilic esophagitis

“…This finding is similar to that of a previous study that described a normal esophagram in 12 of 17 patients with EE [13]. Other studies have described upper GI as having a low sensitivity in the diagnosis of EE [7,8,10,[14][15][16][17]. The clinical and imaging findings of eosinophilic esophagitis can vary depending on the severity and degree of eosinophilic infiltration of the esophagus.…”

“…Several studies have described the fluoroscopic findings of EE [6][7][8][9][10][11][12][13]. The most common findings include proximal esophageal strictures, long-segment esophageal narrowing, esophageal rings (including Schatzki rings) and dysmotility.…”

Eosinophilic Esophagitis

“…Treatment with systemic steroids improved the symptoms, but a post-inflammatory, proximal stricture remained. Others have reported long, irregular, proximal, middle or distal strictures and esopha- geal polyps [29,31,37] . Another radiological clue to the diagnosis of EoE is the Schatzki ring [38] .…”

Eine impaktierte „Wiener Semmel“ im Ösophagus – Erstmanifestation einer eosinophilen Ösophagitis bei einem 17-jährigen Patienten

“…Eine maligne Entartung wurde in keinem Fall beobachtet [46]. Die EÖ kann zu fibrosierenden und stenosierenden Veränderungen im Ösophagus führen, die einer entsprechenden Therapie zugeführt werden müssen [47,48]. In einer kürzlich publizierten Studie kam es bei > 90% der Patienten zu wiederkehrenden Symptomen, obwohl 69% der Patienten mehr als eine Steroidtherapie durchgeführt hatten [49].…”