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Barrett's esophagus in scleroderma: Increased prevalence and radiographic findings

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Abstract

Ten of 27 patients (37%) with scleroderma who underwent endoscopy at our hospital between 1980 and 1984 for symptoms of reflux esophagitis had biopsy-proven Barrett's esophagus. Two of those 10 patients had esophageal adenocarcinomas. In a blinded review of esophagrams (all but 2 using double-contrast technique) from 16 of the 27 patients, only 1 patient was thought to be at high risk for Barrett's esophagus due to a high esophageal stricture with an adjacent reticular pattern of the mucosa. The latter patient had biopsy-proven Barrett's mucosa. Eight patients were thought to be at moderate risk for Barrett's esophagus due to reflux esophagitis and/or distal strictures in 6 and polypoid intraluminal masses in 2. Three of the 6 patients with esophagitis and/or strictures had Barrett's esophagus, and both patients with masses had adenocarcinomas arising in Barrett's mucosa. Finally, 7 patients who had no esophagitis or strictures were thought to be at low risk for Barrett's esophagus. None of those 7 had histologic evidence of Barrett's mucosa. Thus, the major value of double-contrast esophagography is its ability to classify patients into high-, moderate-, and low-risk for Barrett's esophagus to determine the relative need for endoscopy and biopsy in these patients.

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Authors and Affiliations

  1. Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, 19104, Philadelphia, PA, USA

    Michael P. Recht & Marc S. Levine M.D.

  2. Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA

    David A. Katzka & James C. Reynolds

  3. Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Scott H. Saul

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  1. Michael P. Recht
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  2. Marc S. Levine M.D.
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  3. David A. Katzka
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  4. James C. Reynolds
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  5. Scott H. Saul
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Recht, M.P., Levine, M.S., Katzka, D.A. et al. Barrett's esophagus in scleroderma: Increased prevalence and radiographic findings. Gastrointest Radiol 13, 1–5 (1988). https://doi.org/10.1007/BF01889012

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  • DOI: https://doi.org/10.1007/BF01889012

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