Partial regression of childhood Barrett's esophagus after fundoplication

A 12-yr-old boy presented with Barrett's esophagus, the nature and extent of which were thoroughly documented with multiple endoscopic biopsies. He had an excellent symptomatic response to antireflux surgery. Radiologic studies, esophageal manometry, and intraesophageal pH studies were performed before surgery and at intervals thereafter, and documented the success of antireflux surgery. Within 2 yr of surgery, there was endoscopic and histologic evidence of squamous regression of columnar mucosa, and this process of regression to squamous epithelium continued over a further 3 yr. This case suggests that partial squamous regression of Barrett's esophagus may occur in children. Studies dealing with regression are reviewed and proposals are made for a standardized approach to its documentation.