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Abstract:
Three cases are presented in which double-contrast esophagograms revealed one or more plaquelike lesions in the distal esophagus, representing pseudomembrane formation in patients with severe reflux esophagitis. Although to our knowledge this finding has not been reported previously in the radiologic literature, pseudomembranes have been documented endoscopically in patients with reflux esophagitis and biopsy-proved Barrett esophagus. Radiologists should be aware of this finding, since these pseudomembranes may be indistinguishable radiographically from plaquelike carcinomas arising in Barrett esophagus.
Insights
Severe reflux esophagitis can cause plaquelike pseudomembranes in the esophagus. These findings on esophagograms may mimic cancer in patients with Barrett esophagus.
Area of Science:
- Radiology
- Gastroenterology
- Pathology
Background:
- Gastroesophageal reflux disease (GERD) is a common condition.
- Severe reflux esophagitis can lead to esophageal complications.
- Barrett esophagus is a known complication of chronic GERD.
Observation:
- Double-contrast esophagography revealed plaquelike lesions in the distal esophagus.
- These lesions represented pseudomembrane formation.
- This finding was observed in three patients with severe reflux esophagitis.
Findings:
- Pseudomembranes in severe reflux esophagitis have not been previously reported in radiologic literature.
- Endoscopic documentation of pseudomembranes exists in patients with reflux esophagitis and Barrett esophagus.
- Radiographic appearance of pseudomembranes can be similar to plaquelike carcinomas in Barrett esophagus.
Implications:
- Radiologists must be aware of pseudomembranes as a potential finding in severe reflux esophagitis.
- Distinguishing pseudomembranes from malignancy is crucial for appropriate patient management.
- This highlights the importance of correlating imaging findings with endoscopic and biopsy results.