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Esophageal ulcer - Diagnosis
Medical expert of the article
Last reviewed: 06.07.2025
Diagnosis of esophageal ulcers consists of the following measures:
Esophagoscopy
V. M. Nechaev (1997) describes three forms of esophageal ulcers.
- A focal ulcer is a small ulceration (0.3-1 cm in diameter) with clear, smooth, non-raised edges. Peristalsis is preserved, and there is no rigidity of the walls.
- Deep ulcer - larger in size (0.5-3 cm in diameter) with clear, even edges rising above the surrounding tissue, peristalsis is preserved.
- Flat-infiltrative ulcer - in the form of a flat infiltrate with a diameter of 0.3-3 cm with clear boundaries, hyperemic edges, covered with fibrin.
For differential diagnosis with esophageal cancer, all ulcers require a biopsy of the esophageal mucosa followed by histological examination.
X-ray of the esophagus
The main radiographic sign of an esophageal ulcer is a "niche" (i.e. a round or triangular protrusion on the contour of the esophageal shadow), with convergence of the folds of the esophageal mucosa often occurring in the direction of the ulcer. An indirect sign of an ulcer is a persistent contrast spot on the inner surface of the esophagus after the passage of a barium suspension through it.
Daily gastroesophageal pH-metry
This method allows us to prove the presence of a hernia of the esophageal opening of the diaphragm, cardiac insufficiency, and gastroesophageal reflux disease.
Virological examination of biopsy
It is performed to prove the viral etiology of esophageal ulcer. The polymerase chain reaction and DNA hybridization in situ reaction are used.