Diffuse esophageal parakeratosis.
Journal
Endoscopy
Journal Volume
39 Suppl 1
Pages
E119-120
Date Issued
2007
Author(s)
Abstract
A 31-year-old woman, who suffered from chronic alcohol abuse, presented with hematemesis and loss of consciousness 2 hours after ingesting toilet bowl cleaner and sedative pills. Over the previous 6 months she had suffered worsening depressive symptoms, with increased alcohol intake, inadequate diet, and a rapid weight loss of 20 kg. An urgent endoscopy revealed extensive gastric and duodenal hemorrhage as a result of caustic injury. The esophagus was not a source of bleeding; however, it showed an unusual appearance of thick mucosa with orderly displayed rings and furrows (Figure [1] a). The furrows were particularly prominent when the lumen constricted upon irrigation (Figure [1] b). The lesion started with discrete patches at the upper esophagus (Figure [1] c), extended diffusely through the entire esophagus, and ended up at the esophagogastric junction. A section of square-shaped mucosa at the upper esophagus was peeled off by random grasping using biopsy forceps (Figure [1] d). Epithelial parakeratosis was demonstrated by microscopic examination (Figure [2]). The patient was treated with alcohol abstinence, proton-pump inhibitor, standard tube-feeding diet, and supplements of thiamine, pyridoxine, and cyanocobalamine. A follow-up endoscopy 40 days later revealed normal esophageal mucosa except for scattered candidal infections.
SDGs
Type
journal article