Left: 68 year-old man with dysphagia (difficulty swallowing) to solids, and intermittent odynophagia (pain with swallowing). Endoscopy revealed a circumferential distal esophageal ulcer with associated tight stricture formation.
Center: 72 year-old woman with scleroderma and associated chronic reflux, with severe distal esophagitis, stricture formation and extensive, deep ulceration.
Right: 83 year-old man with dysphagia but no odynophagia, pyrosis or dyspepsia. Endoscopy revealed twin "kissing" ulcers just above a lower esophageal stricture through which the endoscope would not pass until after gentle balloon dilation.
Left: 70 year-old woman with hematemesis. Endoscopy demonstrated a long, deep benign distal esophageal ulcer.
Right: 88 year-old woman with hematemesis. Endoscopy revealed severe esophagitis, and a large distal esophageal ulcer with a large protruding "visible" vessel in the center of the ulcer.
SOURCE:Atlanta South Gastroenterology.
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