ABSTRACT
Esophageal atresia and tracheoesophageal fistula
sia with distal tracheoesophageal fistula (<0.5 cm in diameter)
●● Coughing/choking during feeding, aspiration pneumonia
Esophageal stenosis
●● Caused by webs, membranes, GERD, epidermolysis bullosa
ACQUIRED DISEASES
Gastroesophageal reflux disease (GERD)
●● Physiologic GERD during initial months of life; due to immaturity of lower esophageal sphincter/peristalsis
●● Persistent GERD; failure to thrive, irritability, regurgitation, gastrointestinal blood loss
●● Esophageal mucosa: basal cell hyperplasia, lengthening of papillae, spongiosis, intraepithelial lymphocytes, eosinophils and neutrophils
●● Long-term sequelae: Ulcers, bleeding, esophageal strictures, Barrett esophagus
by specialized columnar epithelium with goblet cells (intestinal type)
●● Alcian blue (PH 2.5) stains intestinal-type acid mucins with blue color
●● Long-term sequelae-dysplasia and adenocarcinoma (very rare)
Eosinophilic esophagitis
high-power field, diffuse basal cell hyperplasia, eosinophilic microabscesses
●● Findings are of equal intensity in distal and mid-esophagus
●● Gastric cardia usually not inflamed (differential from reflux esophagitis)
Infectious esophagitis
●● Debilitated, immunosuppressed, premature, or hospitalized children
Herpes simplex esophagitis
trate, ulceration, multinucleated cells ●● Squamous cells have intranuclear inclu-
sions (Cowdry type I and II)
Candida esophagitis
and fibrin
Cytomegalovirus esophagitis
●● Part of systemic cytomegalovirus (CMV) infection mostly
●● The virus does not infect squamous cells (d/d HSV)
CONGENITAL ABNORMALITIES
Hypertrophic pyloric stenosis
●● Projectile non-bilious vomiting due to gastric outlet obstruction
●● Barium studies; elongated pyloric channel (string sign)
●● Hypertrophic, elongated circular muscle layer of muscularis propria in gastric pyloric antrum
Gastric duplication
rupture
Pancreatic heterotopias
ACQUIRED DISEASES
Spontaneous perforation
neum
Gastritis
Hemorrhagic and ischemic gastritis
●● Drugs (NSAIDS, corticosteroids, aspirin, alcohol)
Helicobacter pylori gastritis
bacteria ●● Positive for Giemsa, Warthin-Starry, immu-
noperoxidase stains ●● Lymphoid follicles with germinal centers,
neutrophilic infiltrate, increased clustering of plasma cells
●● Long-term sequelae: Risk of adenocarcinoma and lymphoma of stomach (MALT)
lymphocyte/100 epithelial cells
Helicobacter heilmannii gastritis
●● Clinical and morphological features mimic H. pylori
H. pylori
Peptic ulcer disease
duodenum ●● Associated with antral gastritis and H.
