Acetic acid improves identification of remnant islands of Barrett's epithelium after endoscopic therapy.
BACKGROUND
Instillation of acetic acid onto the uterine cervix at colposcopy has been used for many years to highlight dysplastic areas and thereby enhance the ability to obtain targeted biopsy specimens. As part of an ongoing trial of multipolar electrocoagulation for Barrett's esophagus, we sought to develop a simple technique to identify small islands of residual specialized columnar epithelium after treatment.


METHODS
In 21 consecutive patients, 5 to 10 mL of 1.5% acetic acid was sprayed onto the distal esophagus using a spray catheter, followed immediately by spraying 50 mL of tap water.


RESULTS
Initially, a whitish coloration developed in both esophageal and gastric epithelia. After 2 to 3 minutes, the esophageal squamous mucosa remained white but the columnar epithelium became reddish. Remnant islands of Barrett's epithelium were outlined by a white rim.


CONCLUSIONS
Acetic acid instillation enhances the ability to detect small or indistinguishable remnant islands of columnar epithelium after endoscopic treatment of Barrett's esophagus. This method is safe, rapid, and inexpensive.
Guelrud
M
M
Policlinica Metropolitana, Urb. Caurimare, Caracas, Venezuela.
Herrera
I
I
D019342:Acetic Acid; D001471:Barrett Esophagus / Q000473:pathology* / Q000601:surgery; D004564:Electrocoagulation; D004848:Epithelium / Q000473:pathology; D004945:Esophagoscopy / Q000379:methods*; D006801:Humans; D007202:Indicators and Reagents / Q000008:administration & dosage*; D009092:Mucous Membrane / Q000473:pathology; D010865:Pilot Projects; D011184:Postoperative Period; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D007202:Indicators and Reagents; D019342:Acetic Acid