Impaired esophageal motility( moniliasis versus food remnants)
A55-year-old man with a past history of liver cirrhosis due to HCV. The patient received oral direct antiviral treatment with complete remission of his viral state. The patient on regular sclerotherapy for esophageal varices beginning 2 years ago. One month ago, the patient came for follow up upper GI endoscopy. The endoscopy revealed a deep large duodenal ulcer and gastropathy of the stomach. The interesting thing was a whitish material that covered the esophageal mucosa from its beginning to its end. Multiple trials of washing these materials showed that it is sticky to the esophageal mucosa, but revealed normal mucosa. In my opinion, it is food particles in a patient with severely impaired esophageal motility (notice, there was no any food particles in the stomach). One week later, the patient was admitted to the hospital with a chest infection. chest x-ray revealed severe bronchopneumonia involving nearly the whole left lung. The patient received combination antibacterial and antifungal treatment. Unfortunately, the patient died one week later in the hospital. What is your explanation is it food remnants or esophageal moniliasis and is there a relation between the patient respiratory tract infection and impaired esophageal motility?
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