Esophagitis Dissecans Superficialis: A Frequently Missed and Rarely Reported Diagnosis

Abstract

Esophagitis dissecans superficialis (EDS) is a rare esophageal disease with a wide spectrum of presentations from asymptomatic to debilitating symptoms. There is a strong association of EDS with autoimmune diseases, smoking, and medications, but it can also be idiopathic. Due to the sporadic occurrence of EDS, identification requires a high index of suspicion to avoid frequent misdiagnoses. Herein, we present a case of EDS associated with the long-standing use of oral diclofenac with a favorable outcome after therapy with a proton pump inhibitor (PPI).

Esofagitis disecante superficial: entidad subdiagnosticada en pacientes pluripatológicos

“…La clínica puede variar desde hallazgo incidental en asintomático o presentar dolor epigástrico, disfagia, dolor abdominal, náuseas y vómitos de material esofágico, hematemesis, melena, entre otros. (9,10) En el presente caso, se describe en la endoscopía mucosa esofágica en tercio distal de aspecto "acartonado" asociado a sangrado que se autolimita, características compatibles con lo descrito en otros estudios donde se evidencia que el compromiso más frecuente ocurre en el tercio distal (4) y presenta "hojas" de mucosa parcialmente desprendida o mucosa arrugada. (2,11) Así mismo, en el caso se presenta esfacelación de mucosa, también característica de EDS, la cual la reportan como desprendimiento de mucosa en tiras verticales, con forma de "cinta de papel de regalo" o en parches.…”

“…Por su asociación a patologías autoinmunes, estudios revelan el beneficio de corticoterapia a corto plazo en estos pacientes o los que no tengan respuesta a la terapia clásica. (10,11) Así mismo se aconseja seguimiento a las 8 semanas, aunque no existe evidencia sólida que avale esta recomendación…”

Esophagitis Dissecans Superficialis: A Case Report

“…Despite its seemingly striking appearance, complete healing without complications is frequently achieved following the withdrawal of offending agents. It mostly affects those of older age on multiple medications, although the mechanism remains unclear [ 1 , 2 ]. We present a case of an 81-year-old female diagnosed with EDS following an acute 8-pound weight loss.…”

Hypermetabolic Esophagitis Dessicans Superficialis Mimicking Esophageal Cancer on FDG PET/CT

“…[1][2][3] Esophagitis dissecans superficialis is a benign condition and usually resolves without lasting esophageal pathology. 4,5 Although EDS has been reported in association with autoimmune disorders, certain medications, and esophageal strictures, most cases remain unexplained and idiopathic. 6 In this case, the patient had no gastrointestinal symptoms.…”

“…Esophagitis dissecans superficialis is a term applied to a rare endoscopic finding characterized by sloughing of large fragments of the esophageal squamous mucosa that may be coughed up or vomited 1–3 . Esophagitis dissecans superficialis is a benign condition and usually resolves without lasting esophageal pathology 4,5 . Although EDS has been reported in association with autoimmune disorders, certain medications, and esophageal strictures, most cases remain unexplained and idiopathic 6 .…”