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Esophagitis dissecans superficialis
Esophagitis dissecans superficialis
K. K. Rawal 0
0 Department of Gastroenterology and Liver Disease, Milestone Hospital , Vidyanagar, Main Road, Rajkot 360 002 , India
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Esophagitis dissecans superficialis (EDS) or sloughing
esophagitis is an extremely rare benign illness.
Endoscopically, it is characterized by sloughing of large
fragments of esophageal mucosa that may be coughed up or
vomited out [1]. Although an association with
medications (e.g. bisphosphonates and NSAIDs), skin
conditions (autoimmune bullous dermatosis), heavy smoking,
and physical trauma (e.g. hot beverages, chemical
irritants, and nasogastric intubation) has been reported,
most cases remain unexplained and the histopathological
features of EDS are not adequately described [2].
Usually asymptomatic, occasional symptoms may be
dysphagia, nausea, bleeding, vomiting, heartburn and
odynophagia. The endoscopic features of EDS are single
or multiple translucent or opaque whitish sheets and
fragments of stripped-off mucosa, involving a part or
the entire esophagus (Fig. 1). In spite of a sometimes
dramatic presentation, EDS is a benign condition with
good prognosis and without permanent esophageal
injury. A combination of acid suppression and
discontinuation of precipitating medications results in complete
healing [1].
Fig. 1 Endoscopy showing esophagitis dissecans superficialis with a
whitish opaque sheets of sloughed mucosa covering nearly the entire
esophagus, b translucent and detached sheets of sloughed mucosa at places
1. Carmack S , Vemulapalli R , Spechler S , et al. Esophagitis dissecans superficialis (sloughing esophagitis): a clinicopathological study of 12 cases . Am J Surg Pathol . 2009 ; 33 : 1789 - 94 .
2. Purdy J , Appelman H , McKenna B. Sloughing esophagitis is associated with chronic debilitation and medications that injure the esophagus mucosa . Mod Pathol . 2012 ; 25 : 767 - 75 . (...truncated)