Esophagitis (Reflux)

Figure haem_7a_n.jpg to haem_7c_n.jpg: Esophagoscopy with the demonstration of the distal esophagus in 3 different children with vomiting or dysphagia and regurgitation in haem_7c_n.jpg. haem_7a_n.jpg: View at the closed gastroesophageal transition zone: Mucous membrane exhibiting reddish spots at 7 and 1 o'clock. It is macroscopically a slight form of esophagitis. A precise grading or even the comfirmation of a clinically supposed esophagitis may be possible only by biopsy in the single case. haem_7b_n.jpg: View of the cardia with thick mucosal folds of the stomach beyond it $$haem_4??(alternate picture). The whole back wall of the distal esophagus exhibits map-like reddish and white-yellow zones. In this case there is a more severe form of esophagitis than in haem_7a_n.jpg. Reddening = focus of inflammation, white-yellow zones = erosions or ulcers with fibrin coates. haem_7c_n.jpg: At the end of the visible esophagus there is a permanently narrow lumen and proximally to it a large, irregularly limited and white-yellow area. In addition to the severe form of esophagitis, there is an annular peptic stenosis; the acute esophagitis demonstrates that the reflux is still present which is responsible for the stenosis. At 1 to 11 o'clock the fibrin coat gets loose, and the underlying erosion becomes visible.