LAUSR

A 79-year-old man visited the emergency department complaining of a 3-day history of dysphagia. The patient had been taking dabigatran (220 mg/day) for his permanent atrial fibrillation for the past eight years. His physical examination revealed no pathology. A chest computed tomography (CT) revealed esophageal wall thickening (Figure 1a), and an esophagogastroduodenoscopy revealed vertically oriented white strips of sloughing mucosal casts in the middle thoracic esophagus (Figures 1b and 1c). A histopathological examination of a biopsy specimen of sloughing casts revealed necrosis of the superficial squamous epithelium without evidence of malignancy (Figure 1d). We diagnosed him with dabigatraninduced esophagitis (DIE).