Esophagitis Dissecans Superficialis After Thermal Injury

Abstract

Esophagitis dissecans superficialis (EDS) is a rare esophageal condition characterized by sloughing of the esophageal mucosal epithelium, typically associated with a desquamating dermatologic disorder or mucosal irritants. We present a case of a 49-year-old man who presented for thermal burns sustained from an outdoor heater explosion. On body trauma imaging, he was incidentally found to have a midcervical esophageal prominence causing asymptomatic posterior tracheal compression. Endoscopy with esophageal biopsy were performed and consistent with EDS. He never exhibited symptoms associated with this diagnosis. To our knowledge, thermal injury has been a purported, albeit without case reference, etiology of EDS.

Keywords: endoscopy; esophagitis dissecans superficialis; pseudomembranes; sloughing esophagitis; thermal injury.

Figure 1.

(A) Upper third of esophagus with patches of whitish mucosa. (B) Middle third of esophagus with peeling strips of this mucosa with underlying normal-appearing epithelium. (C) Lower third of esophagus with relatively uniform-appearing mucosa.

Figure 2.

(A) Superficial layers of parakeratosis with early separation from underlying squamous epithelium (hematoxylin and eosin, 400×). (B). Extension of superficial separation, note the lack of inflammatory infiltrate (hematoxylin and eosin, 200×). (C) Complete separation of parakeratotic layer from subjacent normal epithelium (hematoxylin and eosin, 200×).