Background: Precise endoscopic measurement of esophageal landmarks is
difficult and inaccurate because of the ability of the esophagus to le
ngthen and foreshorten. Methods: Nineteen patients enrolled to date in
a study of Barrett's esophagus had an India ink tattoo placed at the
most proximal level of the squamocolumnar junction and were examined e
ndoscopically at 3, 9, 15, 24, and 36 months. Results: Eighteen of nin
eteen patients (94.7%) were judged to have a good to excellent tattoo
persistence at 3 months. One of the 19 patients (5.3%) had poor tattoo
persistence and was retattooed at the 3-month interval. Eventually, 1
5 of the 15 patients (100%) who remained in the study had a good or ex
cellent tattoo persistence at 36 months. There were no complications r
elated to India ink tattooing including chest pain, bleeding, or perfo
ration. At follow-up endoscopy, no ulcers, inflammation, break in the
mucosa, or pain were noted. Conclusion: India ink tattooing in the eso
phagus is safe and persistent and may be used as an effective method f
or longitudinal follow-up of lesions in the esophagus.