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Case Reports
. 2009 Jul-Sep;15(3):193-5.
doi: 10.4103/1319-3767.54747.

Esophageal trachealization: a feature of eosinophilic esophagitis

Abdulrahman A Al-Hussaini  1 , Toufic Semaan, Imad A El Hag
Affiliations
Case Reports

Esophageal trachealization: a feature of eosinophilic esophagitis

Abdulrahman A Al-Hussaini et al. Saudi J Gastroenterol. 2009 Jul-Sep.

Abstract

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.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Barium swallow study reveals multiple esophageal rings (arrows)
Figure 2
Figure 2
Upper endoscopy revels multiple esophageal rings (arrows) and furrowings (arrow head)
Figure 3
Figure 3
(a) Esophageal biopsy with eosinophilic infiltrate >20 eosinophils/HPF (×100); (b) Normal esophageal biopsy 6 weeks after treatment with fluticasone inhaler (×40)
See this image and copyright information in PMC

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