Pediatric Patient

Esophageal squamous papilloma (ESP) is a rare entity observed in pediatric and adult patients. Few case reports showed an association with gastroesophageal reflux disease (GERD) or human papilloma virus infections. We report a case of ESP in a 13 year old female patient with abdominal pain. Laparoscopic cholecystectomy and appendectomy one year ago for the recurrent abdominal pain. Her abdominal pain was intermittent epigastric pain, not related to meals. When her pain persisted, she had a work up for this abdominal pain locally two months prior to coming to our center. Her work up included an upper endoscopy that showed mild chronic gastritis (no evidence of H. Pylori). The biopsies showed chemical gastropathy and normal esophagus and duodenum. Also she had lab work that showed normal labs: CBC, ESR, CMP, urine B-HCG. A breath test for small bowel bacterial overgrowth was also negative. An abdominal CT scan was normal. An abdominal ultrasound was normal. Working on lansoprazole 60 mg daily and was asked to avoid NSAIDs. Two weeks into this treatment she continued to have pain and nausea. The decision was then to start her on amitriptyline 25 mg QHS. Her pain improved on this treatment, however her nausea continued so she was referred to us for a second opinion.

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