Barrett’s Esophagus Case Study 1: Intestinal Metaplasia

Background:

A 62-year-old male presented with complaints of daily heartburn and chest discomfort. These symptoms had been ongoing for seven to eight years but had worsened over the last few months. He underwent an upper endoscopy and Barrett’s esophagus was diagnosed. A nodular area was noted in the lower esophagus and biopsies of this showed high-grade dysplasia. Biopsies of the areas surrounding the nodule showed intestinal metaplasia. He was subsequently referred to IESMG for evaluation and treatment. 

Treatment

Endoscopic examination demonstrated a short segment of Barrett’s esophagus with a nodular area at the gastro-esophageal junction. Optical zoom endoscopy was used to accurately define the areas with suspected dysplasia. Endoscopic mucosal resection (EMR) or mucosectomy was performed allowing successful removal of the abnormal appearing mucosa.

Outcome

The pathology from the EMR specimen confirmed high-grade dysplasia in Barrett’s esophagus. Endoscopy two months later revealed a well-healed scar at the resection site. The patient is doing well without further evidence of dysplasia on surveillance endoscopy.