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Gastroenterologist

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Esophageal ulcer: diagnosis

Alexey Kryvenko, medical expert
Last reviewed: 20.11.2021

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Diagnosis of esophageal ulcers is the following:

Esophagoscopy

VM Nechaev (1997) describes three forms of esophageal ulcers.

Focal ulcer - a small ulceration (0.3-1 cm in diameter) with clear, even, not rising edges. Peristalsis is preserved, the stiffness of the walls is absent.
Deep ulcer - larger (diameter 0.5-3 cm) with clear, even edges that rise above the surrounding tissue, peristalsis preserved.
Plainin-filtering ulcer - in the form of a flat infiltrate with a diameter of 0.3-3 cm with clear boundaries, hyperemic edges, covered with fibrin.

For differential diagnosis with esophageal cancer for all ulcers biopsy of the mucosa of the esophagus is necessary with subsequent histological examination.

X-ray examination of the esophagus

The main radiographic evidence of ulcers of the esophagus is the "niche" (ie, a rounded or triangular protrusion on the esophageal shadow contour), and there is often convergence of the folds of the esophagus mucosa towards the ulcer. An indirect sign of an ulcer is a persistent contrast stain on the inner surface of the esophagus after passing through it a barium suspension.

Daily gastroesophageal pH-metry

This method allows to prove the presence of hernia of the esophageal aperture of the diaphragm, cardia deficiency, gastroesophageal reflux disease.

Virological examination of a biopsy specimen

It is carried out to prove the viral etiology of ulcers of the esophagus. A chain polymerase reaction is used, the DNA hybridization reaction is in situ.