CTICasesIntramural Esophageal Abscess in Eosinophilic Esophagitis
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Imaging findings
Chest computed tomography and barium esophagram in a 39-year-old male with a history of eosinophilic esophagitis demonstrate a thickened, irregular esophageal wall with severe mucosal irregularity and debris within the lumen. A focal, fluid-filled, non-communicating collection is identified within or directly adjacent to the esophageal wall, representing an intramural esophageal abscess or a contained microperforation from prior dilations.
Key takeaways
Eosinophilic esophagitis is a chronic, immune-mediated esophageal disease characterized by eosinophilic infiltration, leading to inflammation, strictures, and tissue fragility. Patients are prone to mucosal tears and transmural or intramural esophageal abscesses, particularly after endoscopic interventions such as dilation, requiring careful medical management as surgical tissue in these patients is highly friable.
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