Difference in localization of esophageal mucosal breaks among grades of esophagitis.
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.


CONCLUSIONS
The circumferential location of esophageal mucosal breaks differs significantly among different grades of esophagitis.
Katsube
Tomoko
T
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
Adachi
Kyoichi
K
Furuta
Kenji
K
Miki
Masaharu
M
Fujisawa
Tomoo
T
Azumi
Takane
T
Kushiyama
Yoshinori
Y
Kazumori
Hideaki
H
Ishihara
Shunji
S
Amano
Yuji
Y
Kinoshita
Yoshikazu
Y
D000368:Aged; D016009:Chi-Square Distribution; D004941:Esophagitis / Q000473:pathology*; D004945:Esophagoscopy; D005260:Female; D005764:Gastroesophageal Reflux / Q000473:pathology*; D006551:Hernia, Hiatal / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology*; D015995:Prevalence; D018709:Statistics, Nonparametric