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Reflux Esophagitis
Atif Zaheer, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Inflammation of esophageal mucosa due to gastroesophageal (GE) reflux

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Manning MA et al: Role of multimodality imaging in gastroesophageal reflux disease and its complications, with clinical and pathologic correlation. Radiographics. 40(1):44-71, 2020
                                          2. Nam JH et al: The influences of visceral fat area on the sites of esophageal mucosal breaks in subjects with gastroesophageal reflux diseases. Gastroenterol Res Pract. 2019:9672861, 2019
                                          3. Richter JE et al: Presentation and epidemiology of gastroesophageal reflux disease. Gastroenterology. 154(2):267-76, 2018
                                          4. Souza RF et al: A new paradigm for GERD pathogenesis. Not acid injury, but cytokine-mediated inflammation driven by HIF-2α: a potential role for targeting HIF-2α to prevent and treat reflux esophagitis. Curr Opin Pharmacol. 37:93-9, 2017
                                          5. Li B et al: Reducing the gastroesophageal reflux with lip-type reinforcement technique during intrathoracic esophagogastrostomy. Hepatogastroenterology. 60(127):1541-6, 2013
                                          6. Pelechas E et al: Gastroesophageal reflux disease: epidemiological data, symptomatology and risk factors. Rev Med Chir Soc Med Nat Iasi. 117(1):183-8, 2013
                                          7. Zagari RM et al: Gastro-oesophageal reflux symptoms, oesophagitis and Barrett's oesophagus in the general population: the Loiano-Monghidoro study. Gut. 57(10):1354-9, 2008
                                          8. Moayyedi P et al: Gastro-oesophageal reflux disease. Lancet. 367(9528):2086-100, 2006
                                          9. Levine MS et al: Diseases of the esophagus: diagnosis with esophagography. Radiology. 237(2):414-27, 2005
                                          10. Dibble C et al: Detection of reflux esophagitis on double-contrast esophagrams and endoscopy using the histologic findings as the gold standard. Abdom Imaging. 29(4):421-5, 2004
                                          11. Hu C et al: Solitary ulcers in reflux esophagitis: radiographic findings. Abdom Imaging. 22(1):5-7, 1997
                                          12. Levine MS: Reflux esophagitis and Barrett's esophagus. Semin Roentgenol. 29(4):332-40, 1994
                                          13. Thompson JK et al: Detection of gastroesophageal reflux: value of barium studies compared with 24-hr pH monitoring. AJR Am J Roentgenol. 162(3):621-6, 1994
                                          14. Levine MS: Radiology of esophagitis: a pattern approach. Radiology. 179(1):1-7, 1991
                                          15. Levine MS et al: Update on esophageal radiology. AJR Am J Roentgenol. 155(5):933-41, 1990
                                          16. Mann NS et al: Barrett's esophagus in patients with symptomatic reflux esophagitis. Am J Gastroenterol. 84(12):1494-6, 1989
                                          17. Levine MS et al: Pseudomembranes in reflux esophagitis. Radiology. 159(1):43-5, 1986
                                          18. Levine MS et al: Fixed transverse folds in the esophagus: a sign of reflux esophagitis. AJR Am J Roentgenol. 143(2):275-8, 1984
                                          19. Creteur V et al: The role of single and double-contrast radiography in the diagnosis of reflux esophagitis. Radiology. 147(1):71-5, 1983
                                          20. Graziani L et al: Reflux esophagitis: radiologic-endoscopic correlation in 39 symptomatic cases. Gastrointest Radiol. 8(1):1-6, 1983
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Inflammation of esophageal mucosa due to gastroesophageal (GE) reflux

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Manning MA et al: Role of multimodality imaging in gastroesophageal reflux disease and its complications, with clinical and pathologic correlation. Radiographics. 40(1):44-71, 2020
                                                                                  2. Nam JH et al: The influences of visceral fat area on the sites of esophageal mucosal breaks in subjects with gastroesophageal reflux diseases. Gastroenterol Res Pract. 2019:9672861, 2019
                                                                                  3. Richter JE et al: Presentation and epidemiology of gastroesophageal reflux disease. Gastroenterology. 154(2):267-76, 2018
                                                                                  4. Souza RF et al: A new paradigm for GERD pathogenesis. Not acid injury, but cytokine-mediated inflammation driven by HIF-2α: a potential role for targeting HIF-2α to prevent and treat reflux esophagitis. Curr Opin Pharmacol. 37:93-9, 2017
                                                                                  5. Li B et al: Reducing the gastroesophageal reflux with lip-type reinforcement technique during intrathoracic esophagogastrostomy. Hepatogastroenterology. 60(127):1541-6, 2013
                                                                                  6. Pelechas E et al: Gastroesophageal reflux disease: epidemiological data, symptomatology and risk factors. Rev Med Chir Soc Med Nat Iasi. 117(1):183-8, 2013
                                                                                  7. Zagari RM et al: Gastro-oesophageal reflux symptoms, oesophagitis and Barrett's oesophagus in the general population: the Loiano-Monghidoro study. Gut. 57(10):1354-9, 2008
                                                                                  8. Moayyedi P et al: Gastro-oesophageal reflux disease. Lancet. 367(9528):2086-100, 2006
                                                                                  9. Levine MS et al: Diseases of the esophagus: diagnosis with esophagography. Radiology. 237(2):414-27, 2005
                                                                                  10. Dibble C et al: Detection of reflux esophagitis on double-contrast esophagrams and endoscopy using the histologic findings as the gold standard. Abdom Imaging. 29(4):421-5, 2004
                                                                                  11. Hu C et al: Solitary ulcers in reflux esophagitis: radiographic findings. Abdom Imaging. 22(1):5-7, 1997
                                                                                  12. Levine MS: Reflux esophagitis and Barrett's esophagus. Semin Roentgenol. 29(4):332-40, 1994
                                                                                  13. Thompson JK et al: Detection of gastroesophageal reflux: value of barium studies compared with 24-hr pH monitoring. AJR Am J Roentgenol. 162(3):621-6, 1994
                                                                                  14. Levine MS: Radiology of esophagitis: a pattern approach. Radiology. 179(1):1-7, 1991
                                                                                  15. Levine MS et al: Update on esophageal radiology. AJR Am J Roentgenol. 155(5):933-41, 1990
                                                                                  16. Mann NS et al: Barrett's esophagus in patients with symptomatic reflux esophagitis. Am J Gastroenterol. 84(12):1494-6, 1989
                                                                                  17. Levine MS et al: Pseudomembranes in reflux esophagitis. Radiology. 159(1):43-5, 1986
                                                                                  18. Levine MS et al: Fixed transverse folds in the esophagus: a sign of reflux esophagitis. AJR Am J Roentgenol. 143(2):275-8, 1984
                                                                                  19. Creteur V et al: The role of single and double-contrast radiography in the diagnosis of reflux esophagitis. Radiology. 147(1):71-5, 1983
                                                                                  20. Graziani L et al: Reflux esophagitis: radiologic-endoscopic correlation in 39 symptomatic cases. Gastrointest Radiol. 8(1):1-6, 1983