Papillomatosis in Reflux Esophagitis

It was either this or the Jigsaw puppet from the Saw movies.

Acute changes in reflux esophagitis include the presence of intraepithelial segmented WBCs, basal cell hyperplasia, papillomatosis ( a saw tooth appearance), and erosions.

Chronic changes include fibrosis (manifesting as a stricture) and Barrett's esophagitis (where you see esophageal epithelium looking more like small intestinal epithelium).