VIDEO: What’s in a name? How a premalignant esophageal condition bears the name Barrett
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In this Endo-Sketch, a Healio video series on clinical conditions named after famous colleagues, Klaus Mergener, MD, of the University of Washington School of Medicine, discusses the origin of Barrett’s esophagus.
According to Mergener, the condition is named after British surgeon Norman Rupert Barrett, who was born in Adelaide, Australia, in 1903 and attended Eton and Trinity colleges in the United Kingdom. He joined St. Thomas Hospital in London after medical school to pursue postgraduate training in surgery and remained there for his entire career.
Although Barrett was a respected surgeon and helped establish the field of thoracic surgery, “the naming of Barrett's esophagus is somewhat curious and a great example of the fact that you can be wrong in your initial description of a condition and still get your name attached to it,” Mergener said.
Barrett’s esophagus, a condition in which normal squamous epithelium is replaced with columnar epithelium and goblet cells in the distal esophagus, may be due to chronic acid exposure from reflux esophagitis and is correlated with an increased risk for esophageal adenocarcinoma.
Mergener noted that in 1950 Barrett published a report, in which he defined the esophagus as being lined by squamous epithelium and suggested that when columnar lining is found in a distal segment, that segment represents the stomach tethered in the chest by a congenitally short esophagus. His colleagues, however, argued that the columnar epithelium-lined structure was actually the esophagus lined with metaplastic epithelium.
“It took Barrett 7 years after his initial publication until he turned around and accepted this viewpoint,” Mergener said. “He continued to do research, publish and speak about this condition, which quickly became known as Barrett's esophagus.”
In recent years, there has been progress in the understanding of Barrett’s esophagus, Mergener said, including the natural history of the condition and management with non-surgical treatments, including radiofrequency ablation, cryoablation or endoscopic mucosal resection.
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Barrett NR. Br J Surg. 1950;doi:10.1002/bjs.18003815005.
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