Yang Eun-Jin, Jung Kee Wook
Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Clin Endosc. 2025 Jan;58(1):1-9. doi: 10.5946/ce.2024.023. Epub 2024 Jul 5.
Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease involving inflammation of the esophagus. Endoscopy is essential in the diagnosis and treatment of EoE and shows typical findings, including esophageal edema, rings, exudates, furrows, and stenosis. However, studies involving pediatric and adult patients with EoE suggest that even a normally appearing esophagus can be diagnosed as EoE by endoscopic biopsy. Therefore, in patients with suspected EoE, biopsy samples should be obtained from the esophagus regardless of endoscopic appearance. Moreover, follow-up endoscopies with biopsy after therapy initiation are usually recommended to assess response. Although previous reports of endoscopic ultrasonography findings in patients with EoE have shown diffuse thickening of the esophageal wall, including lamina propria, submucosa, and muscularis propria, its role in EoE remains uncertain and requires further investigation. Endoscopic dilation or bougienage is a safe and effective procedure that can be used in combination with medical and/or dietary elimination therapy in patients with esophageal stricture for the management of dysphagia and to prevent its recurrence.
嗜酸性食管炎（EoE）是一种涉及食管炎症的慢性免疫介导疾病。内镜检查在EoE的诊断和治疗中至关重要，可显示典型表现，包括食管水肿、环、渗出物、沟和狭窄。然而，涉及儿童和成人EoE患者的研究表明，即使食管外观正常，通过内镜活检也可诊断为EoE。因此，对于疑似EoE的患者，无论内镜外观如何，均应从食管获取活检样本。此外，通常建议在开始治疗后进行随访内镜检查并取活检以评估疗效。尽管先前关于EoE患者内镜超声检查结果的报告显示食管壁弥漫性增厚，包括固有层、黏膜下层和固有肌层，但其在EoE中的作用仍不确定，需要进一步研究。内镜扩张或探条扩张术是一种安全有效的方法，可用于食管狭窄患者，与药物和/或饮食消除疗法联合使用，以管理吞咽困难并防止其复发。
