An Audit of Endoscopic Complications in Adult Eosinophilic Esophagitis Matthew S. Cohen, Adam B. Kaufman, Juan P. Palazzo, Daniel Nevin, Anthony J. DiMarino, Sidney Cohen  Clinical Gastroenterology and Hepatology  Volume 5, Issue 10, Pages 1149-1153 (October 2007) DOI: 10.1016/j.cgh.2007.05.017 Copyright © 2007 AGA Institute Terms and Conditions

Figure 1 Complications in 11 patients with adverse outcomes including mucosal tear, perforation with evidence of pneumomediastinum, and emesis-induced esophageal rupture (Boerhaave’s syndrome). Clinical Gastroenterology and Hepatology 2007 5, 1149-1153DOI: (10.1016/j.cgh.2007.05.017) Copyright © 2007 AGA Institute Terms and Conditions

Figure 2 Endoscopic image of a 25-year-old man with long-standing history of dysphagia to solids with distal esophageal stricture. On gentle pressure with the endoscope, the characteristic vertically extending linear laceration developed. Clinical Gastroenterology and Hepatology 2007 5, 1149-1153DOI: (10.1016/j.cgh.2007.05.017) Copyright © 2007 AGA Institute Terms and Conditions

Figure 3 Frequency of endoscopic findings in (A) overall and (B) complicated and uncomplicated patients. The data reflect previous reports with the most common findings of a feline, trachealized, or ringed esophagus, stricture, white plaques, and linear furrowing. Except for strictures and eosinophilic microabscesses, endoscopic features were similar in both groups. Clinical Gastroenterology and Hepatology 2007 5, 1149-1153DOI: (10.1016/j.cgh.2007.05.017) Copyright © 2007 AGA Institute Terms and Conditions

Figure 4 Esophageal mucosal biopsy from a patient with a prior perforation with significant eosinophilic infiltration (>50 eosinophils/HPF) of the mucosa and submucosa. Clinical Gastroenterology and Hepatology 2007 5, 1149-1153DOI: (10.1016/j.cgh.2007.05.017) Copyright © 2007 AGA Institute Terms and Conditions

Figure 5 Biopsy specimens obtained from complicated cases more frequently showed 40 or more eosinophils/HPF and 50 or more eosinophils/HPF, suggesting that the density of eosinophilic infiltration may help to risk stratify patients for the development of complications. Clinical Gastroenterology and Hepatology 2007 5, 1149-1153DOI: (10.1016/j.cgh.2007.05.017) Copyright © 2007 AGA Institute Terms and Conditions