Eosinophilic oesophagitis as a cause of dysphagia and recurrent food impaction in a young male - long way to diagnosis. A case report

We describe the case of a 32-year-old male with recurrent dysphagia and food impaction caused by eosinophilic oesophagitis. Prior to establishing diagnosis, the patient underwent three oesophagogastroduodenoscopies (EGD) with repeated mucosal biopsies and several diagnoses, e.g. Mallory-Weiss syndrome, gastro-oesophageal reflux disease, were suspected. Despite several mucosal features highly suspicious of being eosinophilic oesophagitis, shown on second EGD, histopathology did not confirm the diagnosis. Histopathologic evaluation of biopsy specimens taken during the third EGD showed eosinophilic infiltration of oesophageal mucosa and confirmed the diagnosis of eosinophilic oesophagitis. The authors conclude that eosinophilic oesophagitis might be a common cause of dysphagia and food impaction in young adults, especially men with associated immunoallergic disorders. This clinical entity is probably underdiagnosed because of the lack of awareness of both endoscopists and pathologists. This might have been the cause of delay of diagnosis in our case, too.