Induction and Aggravation of Mid‐esophageal Ulcers by Endoscopic Biopsy—Report of a Case—

Abstract

Abstract: A 33‐year‐old male was admitted to our hospital with a seven months history of retrosternal pain and odynophagia. On admission the patient could take only liquid or soft diet. An endoscopic examination revealed a mid‐esophageal ulcer. The ulcer was intractable. No known etiological factor of esophagitis was found. A biopsy of the ulcer exacerbated the ulcer and symptoms. Biopsies of normal‐looking esophageal mucosa gave rise to new ulcers at the site of biopsy accompanied by an increase in the symptoms. While these newly formed ulcers healed within 6 weeks, it took an additional 6 months for the primary ulcer to completely disappear. The elimination of hard and hot foods, large boluses, condiments and alcohol from the patient's diet appeared to improve the condition of the ulcer and prevent recurrence. The esophageal mucosa of this patient may have an exaggerated potential to react to mechanical stimulation. Such intractable esophageal ulcers rarely appear in healthy young men and the mechanism of the abnormal reactivity of the esophageal mucosa needs to be clarified.