Cureus · 2026
The Clinical and Diagnostic Spectrum of Esophagitis Dissecans Superficialis: A Comprehensive Retrospective Case Series and Literature Review.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Essâdi Btissam, Bouziane Ayoub, Elmqaddam Ouiam, Koulali Hajar, Zazour Abdelkrim, Ismaili Zahi, Kharrasse Ghizlane
Аннотация
BACKGROUND AND AIM: Esophagitis dissecans superficialis (EDS), also known as sloughing esophagitis, is a rare and likely underdiagnosed desquamative disorder characterized by the exfoliation of large fragments of the esophageal squamous epithelium. Despite its dramatic endoscopic appearance, it is frequently misidentified as candidal or corrosive esophagitis. This study aims to provide a comprehensive analysis of the clinical spectrum, diagnostic hallmarks, and therapeutic outcomes of EDS through a Moroccan retrospective case series and a literature review.
METHODS: We conducted a retrospective observational study of six patients diagnosed with EDS at a tertiary referral center between 2014 and 2025. Clinical, endoscopic, and histopathological data were analyzed alongside a narrative review of the literature conducted through PubMed up to December 2025, focusing on predisposing factors, diagnostic features, therapeutic approaches, and long-term outcomes.
RESULTS: The cohort comprised four men and two women (mean age 59.3 ± 27.7 years). Dysphagia was a universal presenting symptom (100%), often accompanied by weight loss and vomiting. Endoscopic evaluation consistently revealed pathognomonic lamellar or sheet-like mucosal detachment and a "pseudo-tracheal" appearance, predominantly localized in the upper and middle esophageal thirds. Histology confirmed superficial desquamation and intraepithelial cleavage without evidence of malignancy. Potential predisposing factors varied across patients, with chronic medication exposure documented in four cases. Management involved high-dose proton pump inhibitors (PPIs) and withdrawal of offending agents. While 50% of patients achieved complete mucosal healing, the remainder experienced recurrences within one year, requiring iterative endoscopic dilations for symptomatic strictures.
CONCLUSION: EDS is a visually striking but fundamentally benign condition. Clinicians must maintain a high index of suspicion in elderly patients with polypharmacy or those with autoimmune triggers. Recognition of its characteristic endoscopic "cellophane tape" appearance and histopathological cleavage is essential to avoid aggressive interventions. When managed with trigger avoidance and mucosal protection, the overall prognosis is generally favorable.
METHODS: We conducted a retrospective observational study of six patients diagnosed with EDS at a tertiary referral center between 2014 and 2025. Clinical, endoscopic, and histopathological data were analyzed alongside a narrative review of the literature conducted through PubMed up to December 2025, focusing on predisposing factors, diagnostic features, therapeutic approaches, and long-term outcomes.
RESULTS: The cohort comprised four men and two women (mean age 59.3 ± 27.7 years). Dysphagia was a universal presenting symptom (100%), often accompanied by weight loss and vomiting. Endoscopic evaluation consistently revealed pathognomonic lamellar or sheet-like mucosal detachment and a "pseudo-tracheal" appearance, predominantly localized in the upper and middle esophageal thirds. Histology confirmed superficial desquamation and intraepithelial cleavage without evidence of malignancy. Potential predisposing factors varied across patients, with chronic medication exposure documented in four cases. Management involved high-dose proton pump inhibitors (PPIs) and withdrawal of offending agents. While 50% of patients achieved complete mucosal healing, the remainder experienced recurrences within one year, requiring iterative endoscopic dilations for symptomatic strictures.
CONCLUSION: EDS is a visually striking but fundamentally benign condition. Clinicians must maintain a high index of suspicion in elderly patients with polypharmacy or those with autoimmune triggers. Recognition of its characteristic endoscopic "cellophane tape" appearance and histopathological cleavage is essential to avoid aggressive interventions. When managed with trigger avoidance and mucosal protection, the overall prognosis is generally favorable.