The role of esophagoscopy in diagnosis and management of esophagitis in children with cancer.

Esophagitis is a common complication in patients treated for cancer; however, difficulty in determining its etiology on the basis of noninvasive clinical information limits the implementation of specific therapies. We reviewed our experience with esophagoscopy and biopsy as an aid in the diagnosis and management of esophagitis in children with cancer. Of eleven episodes of esophagitis evaluated by esophagoscopy with biopsy, four (36%) had an infectious etiology (two with Candida, one with Herpes simplex virus, and one with viridans streptococci). The absolute neutrophil count, presence of oropharyngeal colonization, and appearance of the esophagus at esophagoscopy were not predictive of the etiology of esophagitis. Esophagoscopy with biopsy affected the management of 4 (36%) patients. We believe this procedure to be a valuable aid in managing esophagitis in children with cancer by providing objective data not otherwise available to the clinician.