Gastroenterology
Case 42: A Man with Barrett's Oesophagus
CASE
A 57‐year‐old man attends the endoscopy department for endoscopic surveillance of his Barrett's oesophagus. He has been ‘screened’ in such a way every two years for the last decade. At his last procedure two years ago he was given the ‘all clear’ with biopsies showing no dysplasia. Since then he has been well and continues to take a proton pump inhibitor (PPI) to suppress heartburn symptoms. He has no other significant medical history. He takes a statin for high cholesterol and a calcium channel blocker for mild hypertension. He stopped smoking 10 years ago.
His endoscopy on this occasion demonstrates a 6‐cm segment of columnar lined oesophagus consistent with Barrett's epithelium. Within this segment there is a small ulcer.
Biopsies taken from the lower oesophagus confirm columnar mucosa with intestinal metaplasia consistent with Barrett's epithelium. The biopsies taken from the ulcer are reported as showing high‐grade dysplasia.
QUESTION 1
Your score this session: 0 of 0
The patient is very worried when he is called back to discuss the histology in the clinic. Do you: