Novel Endoscopic Findings of Lesions with a Short White Hair-like Appearance in the Lower Esophagus

• Published in: Internal Medicine 2024, pp.3396-23
• Main Authors: Adachi, Kyoichi, Okimoto, Eiko, Ebisutani, Yuri, Kishi, Kanako, Ishimura, Norihisa, Miura, Hiroshi, Ishihara, Shunji
• Format: Article
• Language: English
• Subjects: Adult; Aged; Appendages; Atrophy; Body mass index; Diaphragm; Endoscopy, Digestive System; Esophageal Neoplasms - diagnosis; Esophageal Neoplasms - epidemiology; Esophageal Neoplasms - pathology; esophageal papilla; esophageal papilloma; Esophagitis; Esophagitis, Peptic - diagnosis; Esophagitis, Peptic - epidemiology; Esophagitis, Peptic - pathology; Esophagus; Esophagus - diagnostic imaging; Esophagus - pathology; Female; female-predominance; Females; Gastric mucosa; Hair; Hernia; Hernia, Hiatal - complications; Hernia, Hiatal - epidemiology; Hernia, Hiatal - pathology; Humans; Lesions; Localization; Male; Middle Aged; Papilloma; Papilloma - epidemiology; Papilloma - pathology; Prevalence; protrusion; reflux esophagitis
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.3396-23

Objective The presence of a short white hair-like appearance in the lower esophagus has recently been noted during esophagogastroduodenoscopy (EGD) at our institution. Histological findings showed that this formation was a spiked protrusion of the esophageal papilla. The results regarding the prevalence of such lesions in individuals who underwent EGD examinations as part of medical checkup procedures are herein presented. Methods The EGD results of 14,338 individuals (9,225 males, 5,113 females; mean age 54.0±9.8 years) were examined. The findings related to the presence of multiple lesions with a short white hair-like appearance in the lower esophagus of patients with reflux esophagitis, esophageal squamous papilloma, or gastric mucosal atrophy (GMA), as well as the hiatal hernia width, were investigated. Results Endoscopic findings indicating short white hair-like appendages in the lower esophagus were noted in 167 patients, with a prevalence rate of 1.2%. A female sex, younger age, lower body mass index, lower percentages of habitual smoking and drinking, and the presence of esophageal squamous papilloma were characteristic features of cases with such findings. In addition, a significantly lower prevalence of reflux esophagitis and a smaller diaphragmatic hiatus size were observed. A multiple logistic regression analysis indicated that a female sex, absence of reflux esophagitis, presence of esophageal squamous papilloma, and a smaller diaphragmatic hiatus were factors significantly related to the presence of these short white hair-like appendages. An analysis of circumferential localization revealed the main location to be the left-posterior wall. Conclusion This study is the first to report the prevalence of multiple short white hair-like appendages in the lower esophagus. The occurrence of such lesions is inversely associated with the presence of reflux esophagitis.