A normal foodpipe?

Patient was complaining of indigestion and reflux symptoms. 
WHAT IS YOUR DIAGNOSIS?

a) Normal oesophagus

Not quite normal is it?

b) Reflux oesophagitis

This doesn't look like reflux!

c) Adenocarcinoma

Actually the correct answer!

d) SCC

Red nodules, even if surrounding by squamous mucosa are adenocarcinomas (usually)

explanation

You may be surprised to hear that the small nodule at 3 O'clock turned out to be an IMca! It was removed endoscopically. Of course, it's the question then arises; "Should we offer RFA".  The BSG recommends this for patients with Barrett's harbouring flat dysplasia.  However, in this case there is only a tiny, tongue of Barrett's in the 6 O'clock position! Actually, we just gave this a quick blast of APC (at a fraction of the cost of RFA) and it was gone.  However, the patient remains on annual surveillance!