EOSINOPHILIC ESOPHAGITIS

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Lesion: 1/2 under the esophagus, longitudinal furrowing/shearing and the “crêpe paper”

Alberto Ravelli, Practical pediatric gastrointestinal endoscopyractical, 2012

https://en.wikipedia.org/wiki/Eosinophilic_esophagitis

Lesion: 1/3 under the esophagus, image of trachealization

Alberto Ravelli, Practical pediatric gastrointestinal endoscopyractical, 2012

NASPGHAN Internet Image Library

Lesion: White Plaques

World J Gastrointest Pharmacol Ther 2016

Lesion: Esophageal rings with food bolus impaction in esophagus (Stenose)

Initial Management

•Biopsy: > 2 to 4 pieces both proximal + distal esophageal à Histology: basal zone hyperplasia, lamina propria fibrosis, sometimes eosinophilic microabcesses ∆+: ≥ 15 eos/hpf

•Other explorations : Peripheral eosinophilia, specific IgE

•Treatments : Elimination diets, topical steroids, systemic corticosteroids or other ttt should be individualized

Repeat EGD + biopsies in 4–12 weeks

Other images

Fixed esophageal ring

Hirano I at al, Gut 2013

Exudates (plaques)

Hirano I et al, Gut 2013

Furrows (vertical lines)

Hirano I et al, Gut 2013

Oedema (decreased vascular marking)

Hirano I et al, Gut 2013

Transient oesophageal rings (feline oesophagus): excluded EoE

Hirano I et al, Gut 2013

Hirano I et al, Gut 2013

Crepe paper oesophagus (mucosal fragile)

Hirano I et al, Gut 2013

Hirano I et al, Gut 2013

Esophageal Subepithelial Fibrosos in Children with Esinophilic Esophagitis

Chehade M et al Journal of Pediatric Gastroenterology and Nutrition 2017