Esophageal Erosion vs. Ulceration


The distinction between erosion and ulceration occasionally presents a point of confusion. This post is intended to clear that up for you :)

Erosions:

Erosions are denudations limited to the mucosa.

Quick Histo reminder: The esophageal mucosa consists of the surface keratinizing squamous epithelium, lamina propria, and muscularis mucosae. Beyond that is the submucosa, muscularis propria (inner circular layer and outer longitudinal layer) covered by the adventitial layer.

Characteristically erosions are accompanied by a rind of fibrin and inflammatory debris, allowing distinction of a true erosion from an artifactual epithelial denudation that occurs with aggressive tissue handling.

Ulcerations:

Ulcerations extend through and beyond the muscularis mucosae and involve at least the submuocsa

The inflammation associated with erosions and ulceration can be very ugly!! The reactive atypia can sometimes be difficult to distinguish from a dysplastic or neoplastic process. Be sure to carefully examine the ulcer for signs of an infection. We will go into more detail about the causes of ulcerations in a separate post...



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