Eosinophilic esophagitis

Case contributed by Martin Saenz Aguirre
Diagnosis almost certain


Retrosternal food impaction and dysphagia especially for solids. Allergic to shellfish and cloxacillin. No toxic habits or other previous medical history records.

Patient Data

Age: 45 years
Gender: Male

No alterations in the efficacy of the swallowing process were noticed.

A small non-obstructive impression of the cricopharyngeal muscle could be seen in the superior esophageal sphincter.

The esophagus was normal in diameter and showed a light motility dysfunction leading into a slow esophageal emptying. A mucosal abnormality could be seen especially in the proximal esophageal third, with some ring-like small concentric strictures along its surface.

Case Discussion

Gastroscopy was recommended and the diagnosis was confirmed in both proximal and distal esophageal mucosal biopsy.

Eosinophilic esophagitis is an inflammatory disease of the esophagus characterized by the presence of eosinophils in the esophageal wall tissues.

It is an idiopathic disorder (slightly more prevalent in males) and most patients show a previous history of food allergies or intolerance.

Symptoms are usually caused by some specific food exposure (which triggers the activation of eosinophils) and the diagnosis is established by both anatomopathological demonstration of edema and inflammatory cell infiltration with eosinophils and the absence of parasitic infestation or any other cause of eosinophilia.

Symptoms usually respond well to oral steroid therapy, sometimes avoidance of the triggering food is also required.

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