Diagnosis

Endoscopic diagnostic criteria

► Medications (Fig. 3.39)

Location -

Predilection for middle and lower

third

-

Aortic constriction

-

Retrosternal esophagus

-

Just above the distal constriction

Morphology -

Isolated, sometimes confluent lesions,

which may be on opposite walls

("kissing ulcers")

-

Sharply circumscribed mucosal de

fects with punched-out appearance

-

Erythema, erosion, ulceration, pseudo-

membranes

-

Drug residues

Location - Entire esophagus

Morphology - Circumscribed or diffuse erythema

Differential diagnosis

► Distal reflux esophagitis

► Esophageal carcinoma

Checklist for endoscopic evaluation

► Location (in centimeters and relative to constrictions)

► Detectable motility disorder?

Additional Studies

► None (history is important)

Comments

No specific treatment is available. The offending agent should be withdrawn.

Fig. 3.39 Ulcer in the midesophagus.

Medication-induced

Fig. 3.39 Ulcer in the midesophagus.

Medication-induced

Fig. 3.40 Streaky esophagitis due to heavy alcohol consumption b Erosions and pseudomembranes

Fig. 3.40 Streaky esophagitis due to heavy alcohol consumption

Fig. 3.41 Esophagitis caused by an indwelling nasogastric tube a Erosions b Erosions and pseudomembranes

Was this article helpful?

0 0

Post a comment