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Esophageal Mucosal Bridge in a 7-Year-Old

Abbas, Mazen I.; Wilson, Cortney C.; Biko, David M.; Goldman, Matthew D.

Journal of Pediatric Gastroenterology and Nutrition: January 2014 - Volume 58 - Issue 1 - p e1
doi: 10.1097/MPG.0b013e31825a22aa
Image of the Month

Walter Reed National Military Medical Center, Bethesda, MD.

Address correspondence and reprint requests to Mazen I. Abbas, DO, MPH, Walter Reed National Military Medical Center, Bethesda, MD 20889 (e-mail:

The views expressed in this article are those of the authors and do not reflect the official policy or position of the US Army, the US Air Force, the US Navy, the Department of Defense, or the US government.

The authors report no conflicts of interest.

Submissions for the Image of the Month should include high-quality TIF endoscopic images of unusual or informative findings. In addition, 1 or 2 other associated photographs, such as radiological or pathological images, can be submitted. A brief description of no more than 200 words should accompany the images. Submissions are to be made online at, and will undergo peer review by members of the NASPGHAN Endoscopy and Procedures Committee, as well as by the Journal.

A 7-year-old boy presented at age 3 years with severe gastroesophageal acid reflux disease associated with 2 esophageal polyps and ulceration. His disease was refractory to medical management, requiring a Nissen fundoplication that ultimately failed. He re-presented with increased complaints of dysphagia and vague chest pain while taking lansoprazole. Follow-up esophagram and esophagogastroduodenoscopy (Fig. 1) noted multiple polyps, including a mucosal bridge in the upper-third of the esophagus. Snare polypectomy and bridge resection with hot biopsy forceps were performed. Histology of the polyps and the bridge confirmed normal mucosa with no inflammation. A follow-up visit noted resolution of symptoms.



Esophageal polyps in children are uncommon. They are typically seen near the gastroesophageal junction and are associated with polyps located elsewhere in the gastrointestinal tract. Some are thought to be reactive to mucosal injury from trauma or severe gastroesophageal acid reflux disease (1). Others have been described in Crohn disease, eosinophilic esophagitis, Cowden disease, and neurofibromatosis type 1 (2–4). Esophageal mucosal bridges are even rarer in both adult and pediatric populations. Cases have been associated with nasogastric tube trauma, sclerotherapy, Crohn disease, and other inflammatory disorders (5–7). Successful endoscopic treatment for polyps and bridges using snare and argon plasma coagulation has been reported (8).

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© 2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,