Clinical Endoscopy

Review

Role of endoscopy in eosinophilic esophagitis: Eun-Jin Yang, Kee Wook Jung; Clin Endosc 2025;58(1):1-9. Published online July 5, 2024; DOI: https://doi.org/10.5946/ce.2024.023

Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease involving inflammation of the esophagus. Endoscopy is essential in the diagnosis and treatment of EoE and shows typical findings, including esophageal edema, rings, exudates, furrows, and stenosis. However, studies involving pediatric and adult patients with EoE suggest that even a normally appearing esophagus can be diagnosed as EoE by endoscopic biopsy. Therefore, in patients with suspected EoE, biopsy samples should be obtained from the esophagus regardless of endoscopic appearance. Moreover, follow-up endoscopies with biopsy after therapy initiation are usually recommended to assess response. Although previous reports of endoscopic ultrasonography findings in patients with EoE have shown diffuse thickening of the esophageal wall, including lamina propria, submucosa, and muscularis propria, its role in EoE remains uncertain and requires further investigation. Endoscopic dilation or bougienage is a safe and effective procedure that can be used in combination with medical and/or dietary elimination therapy in patients with esophageal stricture for the management of dysphagia and to prevent its recurrence.

Citations

Citations to this article as recorded by

Endoscopic Diagnosis of Eosinophilic Esophagitis Using a Multi-Task U-Net: A Pilot Study
Ga Hee Kim, Jooyoung Park, Seungju Park, Jeongeun Hwang, Jisup Lim, Kanggil Park, Sunghwan Ji, Kwangbeom Park, Jun-young Seo, Jin Hee Noh, Ji Yong Ahn, Jeong-Sik Byeon, Do Hoon Kim, Namkug Kim
Yonsei Medical Journal.2026; 67(2): 112. CrossRef
British Society of Gastroenterology and Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland guidance on best practice for upper gastrointestinal endoscopy
Shahd A Mohamed, Jeyakumar Apollos, John Anderson, Matthew Banks, Aidan Cahill, James Catton, Matthew Cowan, Benjamin R Disney, Paul Dunckley, Jonathan Fletcher, Andrew Fraser, Joanna Gray, John T Green, Helen Griffiths, Hasan Haboubi, Neil Haslam, Tammy
Frontline Gastroenterology.2026; : flgastro-2025-103455. CrossRef
The Dynamic Evolution of Eosinophilic Esophagitis
Amir Farah, Tarek Assaf, Jawad Hindy, Wisam Abboud, Mostafa Mahamid, Edoardo Vincenzo Savarino, Amir Mari
Diagnostics.2025; 15(3): 240. CrossRef
Endoscopic Management of Eosinophilic Esophagitis: A Narrative Review on Diagnosis and Treatment
Andrea Pasta, Francesco Calabrese, Manuele Furnari, Edoardo Vincenzo Savarino, Pierfrancesco Visaggi, Giorgia Bodini, Elena Formisano, Patrizia Zentilin, Edoardo Giovanni Giannini, Elisa Marabotto
Journal of Clinical Medicine.2025; 14(11): 3756. CrossRef
Eosinophilic Esophagitis: Emerging Insights Into Diagnosis and Management
Hyun Ho Choi
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2025; 25(2): 117. CrossRef
When Manometry and Functional Lumen Imaging Probe Disagree: The Current Limitations of the Chicago Classification Version 4.0 and Probable Extended Indications of Functional Lumen Imaging Probe
Kee Wook Jung, John E Pandolfino
Journal of Neurogastroenterology and Motility.2025; 31(3): 304. CrossRef
The Therapeutic Pipeline for Eosinophilic Esophagitis: Current Landscape and Future Directions
Andrea Pasta, Luisa Bertin, Amir Mari, Francesco Calabrese, Amir Farah, Giulia Navazzotti, Matteo Ghisa, Vincenzo Savarino, Edoardo Vincenzo Savarino, Edoardo Giovanni Giannini, Elisa Marabotto
Pharmaceuticals.2025; 18(12): 1882. CrossRef

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Original Articles

Outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms in patients with liver cirrhosis: Young Kwon Choi, Jin Hee Noh, Do Hoon Kim, Hee Kyong Na, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung; Clin Endosc 2022;55(3):381-389. Published online April 20, 2022; DOI: https://doi.org/10.5946/ce.2021.242

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: The treatment of superficial esophageal neoplasms (SENs) in cirrhotic patients is challenging and rarely investigated. We evaluated the outcomes of endoscopic submucosal dissection (ESD) to determine the efficacy and safety of treating SENs in patients with liver cirrhosis.
Methods
The baseline characteristics and treatment outcomes of patients who underwent ESD for SENs between November 2005 and December 2017 were retrospectively reviewed.
Results
ESD was performed in 437 patients with 481 SENs, including 15 cirrhotic patients with 17 SENs. En bloc resection (88.2% vs. 97.0%) and curative resection (64.7% vs. 78.9%) rates were not different between the cirrhosis and non-cirrhosis groups (p=0.105 and p=0.224, respectively). Bleeding was more common in cirrhotic patients (p=0.054), and all cases were successfully controlled endoscopically. The median procedure and hospitalization duration did not differ between the groups. Overall survival was lower in cirrhotic patients (p=0.003), while disease-specific survival did not differ between the groups (p=0.85).
Conclusions
ESD could be a safe and effective treatment option for SENs in patients with cirrhosis. Detailed preprocedural assessments are needed, including determination of liver function, esophageal varix status, and remaining life expectancy, to identify patients who will obtain the greatest benefit.

Citations

Citations to this article as recorded by

Endoscopic resection of early esophageal neoplasia in patients with esophageal varices: a systematic review
Charlotte N. Frederiks, Laura S. Boer, Bas Gloudemans, Lorenza Alvarez Herrero, Jacques J.G.H.M. Bergman, Roos E. Pouw, Bas L.A.M. Weusten
Endoscopy.2025; 57(07): 769. CrossRef
Clinical outcomes of endoscopic submucosal dissection for esophageal squamous cell carcinoma with esophageal varices: Multicenter retrospective study
Yosuke Toya, Waku Hatta, Tomohiro Shimada, Tamotsu Matsuhashi, Takeharu Shiroki, Yu Sasaki, Tetsuya Tatsuta, Jun Nakamura, Norihiro Hanabata, Yohei Horikawa, Ko Nagino, Tomoyuki Koike, Atsushi Masamune, Yoshihiro Harada, Tetsuya Ohira, Katsunori Iijima, Y
Digestive Endoscopy.2024; 36(3): 314. CrossRef
Clinical outcomes of endoscopic submucosal dissection for superficial esophageal neoplasia in close proximity to esophageal varices: a multicenter international experience
Shruti Mony, Bing Hu, Abel Joseph, Hiroyuki Aihara, Lorenzo Ferri, Amit Bhatt, Amit Mehta, Peng-Sheng Ting, Alex Chen, Andrew Kalra, Jad Farha, Manabu Onimaru, Long He, Qi Luo, Andrew Y. Wang, Haruhiro Inoue, Saowanee Ngamruengphong
Endoscopy.2024; 56(02): 119. CrossRef
Risk associated with endoscopic treatment of early upper gastrointestinal cancer in patients with liver cirrhosis and management strategies
Yu-Yong Tan, Yu-Min Qing, Jian Gong, De-Liang Liu
World Chinese Journal of Digestology.2024; 32(2): 102. CrossRef
Radical chemoradiotherapy for superficial esophageal cancer complicated with liver cirrhosis
Hejing Bao, Hehong Bao, Liping Lin, Yuhuan Wang, Longbin Zhang, Li Zhang, Han Zhang, Lingxiang Liu, Xiaolong Cao
PeerJ.2024; 12: e18065. CrossRef
Endoscopic management of early esophageal cancer in patients with concomitant cirrhosis
Linlin Zhu, Zhenming Zhang
Chinese Medical Journal.2024; 137(24): 3142. CrossRef
Endoscopic submucosal dissection for early cancers or precancerous lesions of the upper GI tract in cirrhotic patients with esophagogastric varices: 10-year experience from a large tertiary center in China
Shuai Zhang, Ying-Di Liu, Ning-Li Chai, Yi Yao, Fei Gao, Bo Liu, Zhan-Di He, Lu Bai, Xin Huang, Chao Gao, En-Qiang Linghu, Lian-Yong Li
Gastrointestinal Endoscopy.2023; 97(6): 1031. CrossRef
Endoscopic Submucosal Dissection for Treatment of Early-Stage Cancer or Precancerous Lesion in the Upper Gastrointestinal Tract in Patients with Liver Cirrhosis
Yuyong Tan, Yumin Qing, Deliang Liu, Jian Gong
Journal of Clinical Medicine.2023; 12(20): 6509. CrossRef

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Clinical Outcomes of Percutaneous Endoscopic Gastrostomy in the Surgical Intensive Care Unit: Gyu Young Pih, Hee Kyong Na, Suk-Kyung Hong, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung; Clin Endosc 2020;53(6):705-716. Published online March 31, 2020; DOI: https://doi.org/10.5946/ce.2019.196

Abstract PDF PubReader ePub

Background
/Aims: Percutaneous endoscopic gastrostomy (PEG) is usually performed on patients with chronic underlying diseases in the general ward (GW). This study evaluated the clinical outcomes of PEG performed on patients in the surgical intensive care unit (SICU) compared with those of PEG performed in the GW.
Methods
The medical records of 27 patients in the SICU and 263 in the GW, who underwent PEG between January 2013 and July 2017, were retrospectively reviewed.
Results
The median age of the 27 SICU patients was 66 years, and their median body mass index was 21.1 kg/m². In the SICU group, the median baseline Sequential Organ Failure Assessment (SOFA) score was 4, and the median Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 16. The median interval between surgery and PEG in SICU patients was 30 days, with a PEG failure rate of 3.7%. Acute complications in SICU patients included bleeding (7.4%) and ileus (11.1%), while chronic complications included aspiration pneumonia (7.4%) and tube obstruction (3.7%). The rates of acute and chronic complications did not differ significantly between the SICU and GW groups. The 30-day mortality rate was 14.8% in SICU patients and 5.3% in GW patients (p=0.073).
Conclusions
PEG is a safe and feasible method of enteral feeding for critically ill patients who require ICU care after surgery.

Citations

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Endoscopic gastrostomy as a method of enteral nutrition providing
E. A. Drobyazgin, Yu. V. Chikinev, A. V. Korobeynikov, A. S. Polyakevich, I. V. Peshkova, S. G. Stofin
Filin’s Clinical endoscopy.2025; 67(1): 54. CrossRef
Comparative Outcomes of PEG Patients With and Without Hypoxia: Laboratory Findings, Gastric Biopsy Results and Procedural Sedation Practices
Aysegul Torun Goktas, Ali Muhtaroglu, Ersin Kuloglu, Ahmet Cumhur Dulger
Medical Science and Discovery.2025; 12(3): 93. CrossRef
The impact of incidental endoscopic findings on PEG-related complications in critically ill patients
Özkul Yılmaz Çolak, Neslihan Ünal Akdemir, Melda İşevi, Tuğçehan Sezer Akman, Fatma Ülger
Turkish Journal of Intensive Care.2025; : 1. CrossRef
Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
Gut and Liver.2024; 18(1): 10. CrossRef
A Multicenter Survey of Percutaneous Endoscopic Gastrostomy in 2019 at Korean Medical Institutions
Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon
Gut and Liver.2024; 18(1): 77. CrossRef
Clinical practice guidelines for percutaneous endoscopic gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
Clinical Endoscopy.2023; 56(4): 391. CrossRef
Risk factors and natural history of bedside percutaneous endoscopic versus fluoroscopy-guided gastrostomy tubes in intensive care unit patients
Lucy Ching Chau, Ryan Soheim, Michael Dix, Sarah Chung, Nadia Obeid, Arielle Hodari-Gupta, Cletus Stanton
Surgical Endoscopy.2023; 37(11): 8742. CrossRef
Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
The Korean Journal of Gastroenterology.2023; 82(3): 107. CrossRef
Relative contraindications to percutaneous endoscopic gastrostomy (review of literature)
Yu. O. Zharikov, M. Kh. Gurtsiev, S. Zh. Antonyan, S. F. Askerova, E. I. Chairkina, P. A. Yartsev
Grekov's Bulletin of Surgery.2022; 180(6): 105. CrossRef

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Characteristics of Missed Simultaneous Gastric Lesions Based on Double-Check Analysis of the Endoscopic Image: Eun Jeong Gong, Jeong Hoon Lee, Kyoungwon Jung, Charles J. Cho, Hee Kyong Na, Ji Yong Ahn, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung, Jin-Ho Kim; Clin Endosc 2017;50(3):261-269. Published online August 22, 2016; DOI: https://doi.org/10.5946/ce.2016.056

Abstract PDF PubReader ePub

Background
/Aims: The detection of multifocal lesions is important for the successful management of gastric neoplasms. We investigated the characteristics of missed simultaneous lesions and the reason for the missed diagnoses.
Methods
A total of 140 patients who underwent repeat endoscopy before endoscopic resection between June 2013 and June 2014 were retrospectively reviewed. We classified simultaneous lesions into three groups based on a review of earlier images: group 1, no images of the location of simultaneous lesions were taken; group 2, no corresponding lesion was evident in the previous images; and group 3, simultaneous lesions were visible in the earlier images but a biopsy was not performed.
Results
Simultaneous lesions were found in 12 patients (8.6%) with 13 lesions, comprising 10 dysplasia (76.9%) and three adenocarcinoma (23.1%). Regarding the reasons for missed diagnoses, seven lesions (53.8%) were classified as group 3, five (38.5%) as group 1, and the remaining lesion (7.7%) as group 2. There were no significant differences in the characteristics of the patients with and without simultaneous lesions.
Conclusions
Lesions disregarded or unnoticed during endoscopic examination were the main reason for missed diagnosis of simultaneous lesions. Endoscopists should consider the possibility of simultaneous lesions and attempt to meticulously evaluate the entire gastric mucosa.

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