Most characteristic findings: Ringed esophagus (concentric, thin, web-like strictures)
May coexist with longer strictures
Strictures, webs, and spasm account for symptoms of food and pill impaction within esophagus
• GI involvement
Most common site of GI tract involvement
Nonspecific fold thickening ± submucosal edema
± malabsorption pattern (dilution of barium, etc.)
TOP DIFFERENTIAL DIAGNOSES
• Intestinal parasites and infestation
• Other causes of esophagitis and stricture
• Esophageal webs
PATHOLOGY
• Most patients have history of food intolerance &/or multiple allergies
DIAGNOSTIC CHECKLIST
• Yield of imaging is probably highest in eosinophilic esophagitis
(Left) Films from an esophagram in a 33-year-old woman complaining of food sticking in her esophagus demonstrate several ring-like strictures of the proximal esophagus as well as more distal and longer strictures . These were persistent on multiple films.
(Right) Endoscopic photograph in the same patient shows the same ring-like strictures likened to tracheal rings and considered characteristic of this disorder.
(Left) Spot film from an esophagram in a 7-year-old girl shows a shortened esophagus pulling the stomach into the chest. A mild mid esophageal stricture is also noted. The appearance is diagnostic of esophagitis, but not the specific type.
(Right) Oblique esophagram in the same patient shows the hiatal hernia and stricture again.
as well as more distal and longer strictures 
. These were persistent on multiple films.
into the chest. A mild mid esophageal stricture 
is also noted. The appearance is diagnostic of esophagitis, but not the specific type.
and stricture 
again.
