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Paediatric eosinophilic oesophagitis presenting to the otolaryngologist

Published online by Cambridge University Press:  30 July 2009

R Harris*
Affiliation:
Department of Otolaryngology, St George's Hospital, London, UK
S Mitton
Affiliation:
Department of Paediatric Gastroenterology, St George's Hospital, London, UK
S Chong
Affiliation:
Department of Paediatric Gastroenterology, St Helier Hospital, Sutton, Middlesex, UK
H Daya
Affiliation:
Department of Otolaryngology, St George's Hospital, London, UK
*
Address for correspondence: Mr R L Harris, Department of Otolaryngology, St George's Hospital, Blackshaw Road, London SW17 OQT, UK. Fax: 0207 829 8644 E-mail: bertieharris@yahoo.com

Abstract

Introduction:

The prevalence of eosinophilic oesophagitis is increasing. A Pubmed search for ‘eosinophilic oesophagitis’ and ‘eosinophilic esophagitis’ yielded 345 publications since 1976. Only seven were in otolaryngology journals.1–7 Patients typically present with dysphagia, vomiting, dyspepsia or food impaction and are therefore usually referred to a paediatric gastroenterologist; otolaryngologists are not usually involved in management. A missed diagnosis may result in oesophageal stricture.

Methods:

Two patients, aged two and four years, were referred to the paediatric otolaryngology department with intermittent upper oesophageal food impaction. A paediatric gastroenterologist was involved in the investigation. Histological examination of oesophageal biopsies demonstrated changes consistent with eosinophilic oesophagitis.

Results:

Both patients were expediently diagnosed, investigated and managed.

Conclusion:

A diagnosis of eosinophilic oesophagitis must be considered in patients presenting with food bolus impaction. Early involvement of a paediatric gastroenterology team in the diagnosis is recommended in children presenting with oesophageal symptoms, in order to avoid delayed diagnosis.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2009

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Footnotes

Presented at the International Conference of the European Society of Pediatric Otorhinolaryngology, 8–11th June 2008, Budapest, Hungary.

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