GI Radiology > Esophagus > Esophagitis


Barrett's Esophagitis


Barrett's esophagus is an acquired condition where the normal stratified squamous lining of the distal esophagus undergoes metaplasia to columnar epithelium due to chronic gastroesophageal reflux and reflux esophagitis. The detection of Barrett's esophagus is important because it is believed to be a premalignant condition associated with a significantly increased risk of developing adenocarcinoma. Patients often present with a long-standing history of reflux symptoms or even dysphagia if they have developed peptic strictures. Between 20 to 40% of patients with Barrett's may exhibit no symptoms at all.


Radiological findings

The classic radiologic features of Barrett's consist of high esophageal strictures or deep, penetrating ulcers that are also associated with a sliding hiatal hernia and gastroesophageal reflux. The "high" location of these strictures and ulcers is attributed to fact that they occur at the squamocolumnar junction in the midesophagus. The presence of a delicate reticular mucosal pattern is specific sign of Barrett's. They are often located adjacent to a stricture. On contrast studies, they appear as tiny, barium-filled grooves/crevices on the esophageal mucosa. If the disease has progressed so far as adenocarcinoma, it may appear as a polypoid, ulcerating, infiltrating, or varicoid mass.

Barretts Esophagus

Barrett's - Upper GI swallow of patient with Barrett's esophagus. Arrow points to new transition point of squamo-columnar junction. Note the irregularities of the mucosa inferior to transition point.

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