Barrett’s oesophagus

  • due to chronic gastro-oesophageal reflux
  • causes a specialized non-secretory columnar epithelium to grow cranially in previous site of squamous epithelium
  • 2 cm or more of columnar epithelium needed to reach this diagnosis
  • may develop high grade dysplasia
  • 40 fold risk of developing esophageal carcinoma. 15% develop adenocarcinoma
  • >2 cm involvement needs 2 yearly endoscopic surveillance
barium swallow
  • wide patulous hiatal segment (associated hiatus hernia)
  • dilated segment of esophagus above the hernia which is bell or tent shaped
  • junction of two mucosal types is marked by a slightly contractile ring, here ulceration and secondary strictures occur