Document Detail

Videoendoscopy and histopathology of the esophagogastric junction in patients with gastroesophageal reflux disease.
MedLine Citation:
PMID:  17571232     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIMS: During endoscopy the stomach is considered to rise at the level of the 'gastric' folds; however, anatomical studies have demonstrated that the proximal gastric folds may in fact be esophageal. This prospective study was designed to assess the histopathology of endoscopically visible proximal gastric folds in patients with gastroesophageal reflux disease.
METHODS: 35 consecutive patients (20 males) with gastroesophageal reflux disease underwent video endoscopy, including biopsy sampling from the endoscopically visible esophagogastric junction (0 cm, 0.5 cm and 1.0 cm distal to the rise of gastric folds and 0.5 cm and 1.0 cm proximal to it). Endoscopy was digitally recorded and reviewed for assignment of biopsy level. Columnar-lined esophagus and esophagitis were cataloged according to the Paull-Chandrasoma histopathologic classification and the Los Angeles endoscopic classification.
RESULTS: Endoscopy: Normal endoscopic esophagogastric junction was seen in 11 (31%) patients and visible columnar-lined esophagus < or = 0.5 cm in 24 (69%).
HISTOLOGY: Columnar-lined esophagus extended 1.0 cm in 22.8% of patients and 0.5 cm in 51.4%, distal to the rise of the gastric folds. In all patients columnar-lined esophagus was interposed between squamous epithelium and gastric oxyntic mucosa. Thus, so-called gastric folds contained mucosa of esophageal origin in all patients. Intestinal metaplasia (Barrett esophagus) was detected in eight (22.9%) patients.
CONCLUSIONS: Endoscopy cannot exclude histopathologic columnar-lined esophagus within gastric rugae. Thus, visible 'gastric' folds should not be used for definition of the esophagogastric junction but as a reference landmark for biopsy sampling during endoscopy.
Claudia Ringhofer; Johannes Lenglinger; Margit Eisler; Fritz Wrba; Roland Sedivy; Johannes Zacherl; Enrico P Cosentini; Gerhard Prager; Elena Devyatko; Martin Riegler
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Wiener klinische Wochenschrift     Volume:  119     ISSN:  0043-5325     ISO Abbreviation:  Wien. Klin. Wochenschr.     Publication Date:  2007  
Date Detail:
Created Date:  2007-06-15     Completed Date:  2007-11-05     Revised Date:  2014-07-29    
Medline Journal Info:
Nlm Unique ID:  21620870R     Medline TA:  Wien Klin Wochenschr     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  283-90     Citation Subset:  IM    
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MeSH Terms
Barrett Esophagus / diagnosis*,  pathology
Endoscopy, Digestive System*
Epithelium / pathology
Esophagogastric Junction* / pathology
Gastric Mucosa / pathology*
Gastroesophageal Reflux / diagnosis*,  pathology
Middle Aged
Prospective Studies
Video Recording*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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