El Salvador Atlas of Gastrointestinal VideoEndoscopy. A Large Database of Images and Video Clips with Cases Reported.
El Salvador Atlas of Gastrointestinal VideoEndoscopy
Eosinophilic Esophagitis. Endoscopy may reveal a ringed appearance or linear furrows. Standard biopsy findings reveal severe eosinophilic infiltration; more than 15-20 eosinophils per high-magnification microscopic field are necessary for diagnosis. In contrast to GERD, eosinophilic esophagitis involves the mucosa, submucosa, and, possibly, the muscularis. Multiple food antigens (eg, eggs, nuts, beef, wheat, fish, shellfish, corn, soy) can induce eosinophilic esophagitis; cow's milk protein is the most common precipitant.

Video Endoscopic Sequence 1 of 6.

Eosinophilic Esophagitis

 Endoscopy may reveal a ringed appearance or linear
 furrows. Standard biopsy findings reveal severe
 eosinophilic infiltration; more than 15-20 eosinophils per
 high-magnification microscopic field are necessary for
 diagnosis.

 In contrast to GERD, eosinophilic esophagitis involves the
 mucosa, submucosa, and, possibly, the muscularis.

 Multiple food antigens (eg, eggs, nuts, beef, wheat, fish,
 shellfish, corn, soy) can induce eosinophilic esophagitis;
 cow's milk protein is the most common precipitant.
Eosinophilic esophagitis is a new disease commonly confused with gastroesophageal reflux disease. Because of different treatments, recognition of eosinophilic esophagitis is important. Eosinophilic esophagitis is an allergy-based disorder. It presents commonly in adults as long standing dysphagia, sometimes with food impaction. Radiography is useful but will miss subtle signs of eosinophilic esophagitis. Treatment options are limited to steroid formulations or avoidance of food allergens though compliance, particularly with elemental formulas, remains problematic.

Video Endoscopic Sequence 2 of 6.

 Eosinophilic esophagitis is a new disease commonly
 confused with gastroesophageal reflux disease. Because of
 different treatments, recognition of eosinophilic esophagitis
 is important.

 Eosinophilic esophagitis is an allergy-based disorder. It
 presents commonly in adults as long standing dysphagia,
 sometimes with food impaction. Radiography is useful but
 will miss subtle signs of eosinophilic esophagitis. Treatment
 options are limited to steroid formulations or avoidance of
 food allergens though compliance, particularly with
 elemental formulas, remains problematic.
The patient presents two submucosal mass the one of the antrum that is compatible with Heterotopic Pancreas.

Video Endoscopic Sequence 3 of 6.

 The patient presents two submucosal mass the one of the
 antrum that is compatible with Heterotopic Pancreas
More images and video clips of the submucosal mass.

Video Endoscopic Sequence 4 of 6.

More images and video clips of the submucosal mass
Endoscopic findings are quite typical and include multiple mucosal rings, strictures, linear furrowing, narrowed esophagus, and multiple white papules, although a small percent of patients will have a normal-appearing esophagus. Recognition of this disease for the gastroenterologist has become paramount because of its differentiation from gastroesophageal reflux not only from an etiologic but especially from a treatment point of view. Most studies on treatment and follow-up of eosinophilic esophagitis have been of the order of months to a few years in small populations of patients. food avoidance therapies but long-term trials are desperately needed to elucidate the time course needed for these treatments. Eosinophilic esophagitis is an evolving disease. Recent data continue to support a key role for allergy in its pathogenesis, though gastroesophageal reflux disease as a potential co-factor, particularly in adults, needs further attention

Video Endoscopic Sequence 5 of 6.

 Endoscopic findings are quite typical and include multiple
 mucosal rings, strictures, linear furrowing, narrowed
 esophagus, and multiple white papules, although a small
 percent of patients will have a
 normal-appearing esophagus.

 Recognition of this disease for the gastroenterologist has
 become paramount because of its differentiation from
 gastroesophageal reflux not only from an etiologic but
 especially from a treatment point of view.

 Most studies on treatment and follow-up of eosinophilic
 esophagitis have been of the order of months to
 a few years in small populations of patients. food avoidance
 therapies but long-term trials are desperately needed to
 elucidate the time course needed for these treatments.

 Eosinophilic esophagitis is an evolving disease. Recent
 data continue to support a key role for allergy in its
 pathogenesis, though gastroesophageal reflux disease as a
 potential co-factor, particularly in adults, needs further
 attention.
One of the fascinating issues in eosinophilic esophagitis is understanding the causes of eosinophilic infiltration of the esophagus, an organ normally devoid of eosinophils as compared with blood and the remainder of the gastrointestinal tract. Eosinophilic esophagitis can be suspected clinically, but diagnosis requires pathologic confirmation by finding large numbers of intraepithelial eosinophils throughout the esophagus. The etiology of eosinophilic esophagitis is unknown but atopy and eosinophilia are common, suggesting that eosinophilic infiltration of the esoph-agus may be a response to environmental allergens, leading to esophageal inflammation by the release of a variety of interleukins and cytotoxic proteins. Eosinophils (5-10 per high power field) in the distal esophagus is characteristic of reflux esophagitis, but large numbers of eosinophils (>20 per high power field) infiltrating the esophagus is distinctly unusual.

Video Endoscopic Sequence 6 of 6.

 One of the fascinating issues in eosinophilic esophagitis is
 understanding the causes of eosinophilic infiltration of the
 esophagus, an organ normally devoid of eosinophils as
 compared with blood and the remainder of the
 gastrointestinal tract.

 Eosinophilic esophagitis can be suspected clinically, but
 diagnosis requires pathologic confirmation by finding large
 numbers of intraepithelial eosinophils throughout the
 esophagus. The etiology of eosinophilic esophagitis is
 unknown but atopy and eosinophilia are common,
 suggesting that eosinophilic infiltration of the esophagus
 may be a response to environmental allergens, leading to
 esophageal inflammation by the release of a variety of
 interleukins and cytotoxic proteins

 Eosinophils (5-10 per high power field) in the distal
 esophagus is characteristic of reflux esophagitis, but large
 numbers of eosinophils (>20 per high power field)
 infiltrating the esophagus is distinctly unusual.