Pathology: esophagitis

As one of the causes of upper GI bleeding, esophagitis may occur in the liver patient too!  In fact, esophagitis has several connections to liver disease.  The alcoholic patient is at risk.  The obese patient with NASH is at risk (acid reflux).  The cholestatic liver disease patient (PBC/PSC) gets metabolic bone disease…and bisphosphonates can cause esophagitis when not taken properly.  These are three examples.

In the image above, the linear erosions in the distal esophagus are discrete, and span more than 1.5 cm, so it can be classified as LA Grade B.  A proton pump inhibitor is indicated, as well as targeting any underlying causes. 

Special mention goes to the immunocompromised, transplant recipient.  Be certain that erosive, esophageal lesions are not ulcers, which might be attributed to a virus like CMV or HSV.

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