UTRGV-DHR Gastroenterology Fellowship Program Edinburg, TX
Mohammad Shakhatreh, MD1, Ans Albustamy, MD2, Grigoriy Rapoport, MD3, Asif Zamir, MD, FACG2 1UTRGV-DHR Gastroenterology Fellowship Program, Edinburg, TX; 2University of Texas Rio Grande Valley at Doctors Hospital at Renaissance, Edinburg, TX; 3UTRGV-DHR Gastroenterology Fellowship Program, Plano, TX
Introduction: Esophagitis dissecans superficialis (EDS) is a desquamative disorder of the esophagus, with little being understood behind its pathogenesis. It has been associated with medications, notably bisphosphonates, NSAIDs, hot beverages and caustic chemicals. It involves direct contact injury rather than an ischemic injury. It is often an incidental finding and represents a benign condition without complications. We present a case of NSAID-induced EDS in a patient with gastric sleeve surgery.
Case Description/Methods: A 63-year-old male with history of morbid obesity status post gastric sleeve surgery 10 years prior presented to the GI clinic for gastric bypass conversion. Documented medications included acetaminophen and diclofenac for arthritic pain. Physical exam revealed BMI of 50.4. EGD revealed esophageal sloughing whitish membranes adjacent to healthy mucosa. Multiple biopsies were taken and final pathology revealed features compatible with EDS with reactive epithelial atypia. The patient was started on oral PPI therapy and advised to avoid NSAIDs. Patient recovered well.
Discussion: Esophagitis dissecans superficialis has been associated with esophageal iatrogenic injury (sclerotherapy band ligation, dilation and mediastinal radiation). It has been reported in post-gastric bypass surgery patients, but to our knowledge, no cases have been reported after a gastric sleeve procedure. Our case poses the question whether the use of NSAIDs in post-gastric sleeve patients predisposes them to develop EDS.
Figure: a,b,c) endoscopic views of "sloughing" esophagus dessicans
Disclosures:
Mohammad Shakhatreh indicated no relevant financial relationships.
Ans Albustamy indicated no relevant financial relationships.
Grigoriy Rapoport indicated no relevant financial relationships.
Asif Zamir indicated no relevant financial relationships.
Mohammad Shakhatreh, MD1, Ans Albustamy, MD2, Grigoriy Rapoport, MD3, Asif Zamir, MD, FACG2. A0212 - Esophagitis Dissecans Superficialis After Gastric Sleeve: A Case Report, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.
