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Difference in localization of esophageal mucosal breaks among grades of esophagitis
Author(s) -
Katsube Tomoko,
Adachi Kyoichi,
Furuta Kenji,
Miki Masaharu,
Fujisawa Tomoo,
Azumi Takane,
Kushiyama Yoshinori,
Kazumori Hideaki,
Ishihara Shunji,
Amano Yuji,
Kinoshita Yoshikazu
Publication year - 2006
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2006.04297.x
Subject(s) - esophagitis , medicine , reflux esophagitis , hiatal hernia , gastroenterology , esophagus , reflux , endoscopy , esophageal disease , significant difference , disease
Background: Gastroesophageal reflux occurs mainly during the daytime in patients with Los Angeles grade A esophagitis, but predominantly during the night in patients with grade C and D esophagitis. The purpose of the present paper was to investigate whether this difference in the pattern of gastroesophageal reflux influences the circumferential localization of erosions in the esophageal wall. Methods: The subjects were 394 consecutive patients diagnosed endoscopically as having reflux esophagitis (grade A, n = 223; B, n = 93; C, n = 53; D, n = 25 cases). Their endoscopic films were reviewed retrospectively to determine the circumferential location of esophageal mucosal breaks, and also the prevalence and size of hiatal hernia (HH). Results: The numbers of mucosal breaks analyzed in patients with grade A, B and C esophagitis were 321, 173 and 54, respectively. Patients with grade A and B esophagitis had longitudinal mucosal breaks mainly in the right‐anterior wall of the lower esophagus, whereas patients with grade C esophagitis had transverse mucosal breaks mainly in the posterior wall. The prevalence and size of HH was significantly higher and larger, respectively, in patients with grade C or D esophagitis than in those with grade A and B esophagitis. Conclusion: The circumferential location of esophageal mucosal breaks differs significantly among different grades of esophagitis.