Git Case Iee08.

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GIT case: eosinophilic esophagitis.

Transcript of Git Case Iee08.

Idiopathic Eosinophilic Esophagitis(IEE): Literature review.

Dr. Mohammad Shaikhani.

Assistant professor

Sulaimaneyah University.

College of Medicne.

Department of Medicine.

Kurdistan center for GIT& Hepatology

Young girl with repeated attacks Young girl with repeated attacks of food bolus impaction: of food bolus impaction:

A 20 YEARS OLD Girl presented with food impaction on eating chicken.

She had further 3 similar attacks lately & even more during childhood.

Some of these attacks were improved spontaneously. She had H/O of 2 other occasions during which food impaction

was treated by endoscopy without biopsies been taken. Generally well with no features of scleroderma or other obvious

physical external findings. CBP& ESR was normal. UGI endoscopy done shown below, biopsies taken&waiting

results She was sent for Ba Swallow.

Bolus impacted: Bolus impacted:

Bolus pushed to theBolus pushed to thestomach: stomach:

Eso after Eso after disimpaction:disimpaction:Narrow,inflammedNarrow,inflammed & ringed & ringed

Eso after Eso after disimpaction:disimpaction:Narrow,inflammedNarrow,inflammed & ringed & ringed

Eso after Eso after disimpaction:disimpaction:Narrow,inflammedNarrow,inflammed & ringed & ringed

Eso after Eso after disimpaction:disimpaction:Narrow,inflammedNarrow,inflammed & ringed & ringed

Described first in 1993. Increasingly recognized as a distinct form of esophagitis in children, less commonly, adults. Adults,typically young men (20 –40) with long-standing dysphagia& recurrent food impactions not responding to usual antireflux therapy, less common is chest pain/ vomiting. The cause uncertain,mostly inflammatory response to ingested food allergens,supported by clinical and histologic response to antiallergies as steroids/ elemental diets (ie, diets free of proteins).Dignosis: presence of an eosinophilic infiltrate (> 20 eos /HPF) in endoscopic eso biopsies(shows ringed feline eso).Barium: segmental eso strictures , diffuse eso narrowing, with a “smallcaliber” eso & distinctive ring-like indentations.

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Esophageal StrictureEsophageal Stricture

Small caliber esophagusSmall caliber esophagus

Pre-endoscopyPre-endoscopy Post-endoscopyPost-endoscopy