Esophagitis Dissecans Superficialis Due to Possible Fishbone Ingestion: A Case Report

Introduction: Esophagitis Dissecans Superficialis (EDS) is a rare, underrecognized mucosal disorder of the esophagus. It is often associated with certain medications, systemic diseases, or direct esophageal trauma. Diagnosis is challenging due to its overlap with other esophageal conditions and the lack of standardized criteria. Case presentation: We report the case of a 38-year-old woman presenting with acute chest pain, dysphagia, and hematemesis following suspected fishbone ingestion. Initial endoscopic findings revealed sloughed esophageal mucosa with friability predominantly in the upper and mid-esophagus. Supportive management with high-dose proton pump inhibitor therapy and dietary modification resulted in rapid clinical improvement. Follow-up endoscopy at day 56 demonstrated complete resolution of mucosal abnormalities, and esophageal biopsies showed normal squamous epithelium. Based on the characteristic endoscopic findings, exclusion of alternative diagnoses, and benign, self-limited course, the presentation was most consistent with EDS, with fishbone ingestion considered a probable precipitating factor. Conclusion: This case highlights mechanical esophageal trauma due to possible fishbone ingestion as a rare but plausible trigger for EDS and underscores the importance of recognizing this entity in patients presenting with acute chest pain and upper gastrointestinal bleeding. Increased awareness of EDS may facilitate accurate diagnosis and prevent unnecessary interventions.