The ‘‘shaggy esophagus’’

摘要

The "shaggy esophagus" has been used to describe the appearance of severe Candida esophagitis, as seen on esophagography. An early description of this distinctive radiologic appearance occurred in 1960 by Kaufman et al. [1]. The esophageal mucosal contour is grossly irregular which is caused by numerous coalescent pseu-domembranes and plaques with trapping of barium between them (Fig. 1) [2]. This appearance can be likened to shag carpet (Fig. 2). Candida esophagitis in its milder form is characterized by multiple linear longitudinal lesions that have a plaque-like appearance with adjacent areas of preserved normal mucosa [2]. Candida esophagitis is the most common cause of infectious esophagitis and primarily occurs in immuno-compromised patients [3]. Predisposing factors include HIV/AIDS, immunosuppressive therapy, diabetes melli-tus, esophageal dysmotility, antibiotic use, and malignancy. Patients typically present with dysphagia and odynophagia often with simultaneous oral thrush. AIDS should be highly suspected when a "shaggy" esophagus is observed as this degree of mucosal irregularity is rarely seen in other immunocompromised conditions [4].