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Barrett’s Esophagus Case Study 2: Low-Grade Dysplasia
Background
A 59-year-old male was diagnosed with Barrett’s esophagus five years ago. On his last surveillance endoscopy, random biopsies of Barrett’s mucosa showed low-grade dysplasia. The patient was referred to IESMG for further evaluation and treatment.
Treatment
Endoscopic examination including optical zoom endoscopy and narrow band imaging (NBI) demonstrated a 5cm segment of Barrett’s esophagus. No nodules or raised lesions were noted in the esophagus. Endoscopic ultrasound (EUS) examination revealed normal wall layers of the esophagus with no evidence of invasive tumor. Treatment of the entire segment of Barrett’s esophagus with radiofrequency ablation (RFA) was performed.
Outcome
The patient required three sessions of radiofrequency ablation for complete eradication of Barrett’s esophagus, which was replaced with normal squamous tissue. The patient continues to be asymptomatic on anti-acid (PPI) therapy and free of Barrett’s mucosa at follow-up.
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- Circumferential Radiofrequency Ablation (RFA) of the lower esophagus performed using the Halo 360 device (mucosa appears white after delivery of treatment). Picture is taken using ultraslim endoscope alongside RF ablation catheter.
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- Circumferential Radiofrequency Ablation (RFA) of the lower esophagus performed using the Halo 360 device (mucosa appears white after delivery of treatment). Picture is taken using ultraslim endoscope alongside RF ablation catheter
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- Endoscopic examination two months after treatment completion shows replacement of Barrett’s mucosa with normal squamous tissue throughout the esophagus
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