Radiology of esophagitis: a pattern approach

Area of Science:

• Radiology
• Gastroenterology
• Pathology

Background:

• Esophagitis diagnosis relies on various imaging and endoscopic techniques.
• Double-contrast esophagography offers a detailed view of esophageal mucosal patterns.
• Differentiating causes of esophagitis is crucial for appropriate patient management.

Purpose of the Study:

• To present a pattern-based diagnostic approach for esophagitis using double-contrast esophagography.
• To correlate specific radiographic findings with distinct causes of esophagitis.
• To enhance diagnostic accuracy in identifying esophageal inflammatory conditions.

Main Methods:

• Analysis of double-contrast esophagography findings in patients with esophagitis.
• Correlation of mucosal patterns (nodules, plaques, ulcers, folds) with clinical diagnoses.
• Evaluation of lesion location and morphology for diagnostic clues.

Main Results:

• Discrete plaques suggest Candida esophagitis; poorly defined nodules suggest reflux esophagitis.
• Reticular patterns may indicate Barrett esophagus, especially near strictures.
• Shallow ulcers near the gastroesophageal junction suggest reflux; midesophageal ulcers suggest herpes or drug-induced esophagitis.
• Giant ulcers suggest cytomegalovirus esophagitis, particularly in immunocompromised patients.
• Thickened folds can indicate esophagitis, varices, or carcinoma, often distinguishable radiographically.

Conclusions:

• Double-contrast esophagography, by analyzing specific patterns, can effectively suggest the cause of esophagitis.
• Radiographic interpretation of mucosal abnormalities aids in differentiating various esophagitis etiologies.
• This pattern-based approach improves diagnostic capabilities in esophageal diseases.