Saudi Journal of Gastroenterology
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Year : 2009  |  Volume : 15  |  Issue : 3  |  Page : 193-195

Esophageal trachealization: A feature of eosinophilic esophagitis

1 Department of Medicine, Children's Hospital, King Fahad Medical City, King Saud Medical Complex, Riyadh, Saudi Arabia
2 Department of Pathology, Children's Hospital, King Fahad Medical City, King Saud Medical Complex, Riyadh, Saudi Arabia

Correspondence Address:
Abdulrahman A Al-Hussaini
Children's Hospital, King Fahad Medical City, P.O. Box 59046, Riyadh - 11525
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-3767.54747

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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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