Image Challenge – May 15th, 2022

Question: Based on the picture from endoscopy seen below, what is your diagnosis?

Reference here – see below

Answer: This is eosinophilic esophagitis. The above image from endoscopy is showing trachealization of the esophagus. Patients may present with dysphagia/odynophagia, food impaction, reflux symptoms, and chest/abdominal pain. Atopic symptoms, previous esophageal perforation or severe pain after esophageal dilatation should raise suspicion for this diagnosis. Upper endoscopy with biopsies is performed for diagnosis and evaluation for other causes of eosinophilia of the esophagus.


  1. File: Multi ring esophagus.jpg. (2020, October 16). Wikimedia Commons, the free media repository. Retrieved 16:28, May 22, 2022 from

2. Authors: Bonis, P. A. L., Gupta, S. (2022). Clinical manifestations and diagnosis of eosinophilic esophagitis. Section Editor: Talley, N. J. Deputy Editor: Robson, K. M. UpToDate. Reference: Accessed on May 22, 2022

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