Purpose or Case Report: Eosinophilic esophagitis (EOE) is the most common esophageal disorder in children and adolescents, with a prevalence of approximately 1 in 1,000. Pathologically characterized by eosinophilic infiltration of the esophageal mucosa, EOE can cause a variety of symptoms, including dysphagia, food refusal, vomiting, and pain. Complications include strictures, dysmotility, and failure to thrive. When clinical providers are concerned for potential EOE, often an Esophagram or Upper GI is the initial imaging study requested before performing the gold standard, but more invasive evaluation, endoscopy with biopsy.

This educational poster will review the background and current standard-of-care imaging for EOE, including fluoroscopic esophagrams and endoscopy. We will review diagnostic tips and tricks for performing and interpreting esophagrams, and highlight the importance and techniques for timed pill-esophagrams, particularly in the evaluation for EOE. We will include emerging information on normative esophageal measurements in pediatric age ranges for reference, as well as highlight subtle fluoroscopic features of EOE to help improve our diagnostic sensitivity and specificity. Our poster will review findings in a case-based format with fluoroscopic and endoscopic images, individual patient treatment plans, with post therapy images in select cases.

Radiologists play an important role in the initial diagnosis and are partners in management and follow-up of patients with EOE. Understanding optimal fluoroscopic techniques and identifying key imaging findings are critical to improving early diagnosis and monitoring response to therapy.
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