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Images in Paediatrics
Esophageal desquamation in pediatrics. Esophagitis dissecans superficialis
Descamación esofágica en pediatría. Esofagitis disecante superficial
Bruna Surinyac-Ayatsa,
Corresponding author
bsurinyac@santpau.cat

Corresponding author.
, Sara Serra Fonta, Jocelyn Betancourta, Justyna Szafranskab, Susana Boronata
a Servicio de Pediatría, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
b Servicio de Anatomía Patológica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histological section of proximal oesophagus &#40;haematoxylin-eosin stain&#44; &#215;4 magnification&#41;&#46; Visualization of sloughed-off superficial mucosal layer composed of parakeratotic material with coagulative necrosis &#40;red star&#41;&#44; with space between the viable and the necrotic mucosa &#40;blue star&#41;&#46; The arrows point at bacteria adhered to the surface of the mucosa&#46;</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">No evidence of viral inclusion bodies or fungal infection&#46; The intraepithelial eosinophil count was greater than 15 per high-power field in every biopsy sample&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A female patient aged 15 years presented with epigastric pain and heartburn and evidence of gastro-oesophageal reflux &#40;reflux index of 10&#46;5&#37; in pH monitoring&#41; and oesophagitis grade A in the upper gastrointestinal &#40;GI&#41; endoscopy&#44; compatible with peptic oesophagitis&#46; Treatment was initiated with proton pump inhibitors &#40;PPIs&#41; at a dose of 40&#8239;mg&#47;day for 2 months&#44; which achieved improvement of symptoms&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient dropped out of follow-up and discontinued treatment&#44; but made another visit 8 months later&#46; She underwent an upper GI endoscopy that revealed&#44; in the upper third of the oesophagus and 20&#8239;cm from the dental arch&#44; an area of sloughing&#44; whitish mucosa extending over &#188; of the oesophageal circumference &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; The histological features &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41; were compatible with compatible con oesophagitis dissecans superficialis &#40;ODS&#41;&#44; prompting prescription of a 1-month course of high-dose PPIs &#40;40&#8239;mg every 12&#8239;hours&#41;&#46; Two months later&#44; the follow-up upper GI endoscopy confirmed full macroscopic and histological normalization&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Oesophagitis dissecans superficialis is rare in children&#44; and the paediatric literature on the subject is scarce&#46; Its development has been associated with the use of certain medications<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and recent studies have found an association with oesophageal food impaction in the context of eosinophilic esophagitis&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> Whether ODS is a disease in itself or a histological sequela of toxic or contact injury has yet to be established&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In conclusion&#44; ODS could be considered a nonspecific endoscopic finding that can be found in the context of different forms of oesophageal mucosal damage and which has a benign natural history&#46;</p></span>"
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histological section of proximal oesophagus &#40;haematoxylin-eosin stain&#44; &#215;4 magnification&#41;&#46; Visualization of sloughed-off superficial mucosal layer composed of parakeratotic material with coagulative necrosis &#40;red star&#41;&#44; with space between the viable and the necrotic mucosa &#40;blue star&#41;&#46; The arrows point at bacteria adhered to the surface of the mucosa&#46;</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">No evidence of viral inclusion bodies or fungal infection&#46; The intraepithelial eosinophil count was greater than 15 per high-power field in every biopsy sample&#46;</p>"
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ISSN: 23412879
Original language: English
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Anales de Pediatría (English Edition)