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- W2977326336 abstract "Purpose: A 15 yr old female was evaluated for chronic abdominal pain and diarrhea. History was negative for dysphagia, nausea and emesis. Prior medications included cetirizine and omeprazole. She had no personal or family history of GI mucosal disease or painful skin lesions. Exam was normal except for mild diffuse abdominal tenderness. Labs, including CBC, CMP, ESR, stool studies, IgA transglutaminase and endomysial antibodies were normal. Gliadin IgA was elevated at 40 units. EGD and colonoscopy were ordered. Cleanout for colonoscopy was bisacodyl 5 mg followed by 527 g of PEG 3350 mixed in 64 oz of a sports drink. At endoscopy, esophageal mucosa was noted to be sloughing in approximately 1 cm wide ribbon-like vertical strands that extended the length of the esophagus, filling the lumen with a “gift wrap ribbon” appearance. No gastric or duodenal mucosa abnormalities were identified. Esophageal biopsies showed variably necrotic fragments of superficial squamous mucosa with patchy active inflammation and parakeratosis with negative fungal stains, consistent with Esophagitis Dissecans Superficialis (EDS). Gastric and duodenal biopsies were normal. Colonoscopy with biopsy was also normal. Compliance with omeprazole was emphasized. On repeat endoscopy performed 1 month later, esophageal mucosa appeared entirely normal with no stricture and normal biopsies. EDS is a rare endoscopic finding characterized by sloughing of large fragments of the esophageal squamous mucosa. It has been associated with certain medications including biphosphonates and dermatologic conditions such as pemphigus vulgaris. Most cases, however, remain unexplained. This condition has never been previously reported in a pediatric patient. Although dramatic in appearance, this is typically a benign condition and resolves spontaneously as in our patient. A history of recurrent painful skin ulcers should prompt dermatologic referral. The medication list should also be carefully reviewed to identify potential causes. In our patient, the bowel preparation the day prior to initial procedure may have been etiologic." @default.
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- W2977326336 date "2011-10-01" @default.
- W2977326336 modified "2023-09-25" @default.
- W2977326336 title "Esophagitis Dissecans Superficialis - An Unexpected Finding at Upper Endoscopy in a Pediatric Patient" @default.
- W2977326336 doi "https://doi.org/10.14309/00000434-201110002-01076" @default.
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