Esophagitis Dissecans Superficialis in Children.

Objectives Esophagitis dissecans superficialis (EDS) is a desquamative disorder of the superficial esophageal epithelium with variable clinical characteristics. Endoscopically there is an appearance of superficial peeling of sheets of epithelium. Histologically there is two-toned epithelium with coagulative necrosis of the superficial epithelium. Currently, there is paucity of data regarding this condition in children. Methods A ten-year retrospective search of the pathology information system was performed for cases with a pathologic diagnosis of EDS in a tertiary care pediatric center. Demographic data, clinical history, endoscopic findings and histopathologic reports were reviewed. Results Thirteen patients (nine female; ages 3-18 years), were identified with histologic findings of EDS. Esophageal food impaction, dysphagia, vomiting, and abdominal pain were the most common presenting symptoms. Sixty-nine percentage of the patients had underlying comorbidities and 76% were on at least one medication chronically. Eosinophilic esophagitis (23%), inflammatory bowel disease (23%) and gastro-esophageal reflux disease (15%) were the most common associated diagnoses. Of the 13 patients, five had repeat endoscopies showing complete resolution of EDS with no complications. Conclusions EDS is an under-recognized entity that endoscopists should be familiar with. In our series, the most prevalent associations were with food impaction and eosinophilic esophagitis. Contact injury and/or inflammation may precede the development of EDS. Pediatric EDS appears to be an incidental finding without significant morbidity or mortality.