From Zucker EL, Nagendra G, Bhardwaj V. A 3-year-old male with unusual esophageal stricture. Pediatrics. 2020;146:471-472.
Esophagram obtained in a 3-year-old boy demonstrates smooth tapering of the distal esophagus at the T7-8 level, which is compatible with esophageal stricture. The smooth appearance without any areas of mucosal irregularity or ulceration suggests a congenital etiology or prior caustic esophageal injury. An enteric tube was used to introduce contrast material, as the patient refused to drink it. Pathology revealed esophagitis with basal cell hyperplasia, >36 eosinophils per high-powered field, subepithelial fibrosis, and papillary sclerosis. The patient was diagnosed with EoE, and budesonide slurry was started.