title: Bleeding and stenosis caused by reflux esophagitis was not common in emergency endoscopic examinations: a retrospective patient chart review at a single institution in Japan.
abstract: BACKGROUND
  Bleeding and stenosis are serious complications of reflux esophagitis, although few studies have been performed in Japan regarding these complications. This study aimed to indicate the characteristics of reflux esophagitis observed during emergency endoscopic examination in Japan.
  
  
  METHODS
  All subjects who had emergency endoscopic examination performed between 1990 and 2004 at Saga Medical School Hospital were evaluated. Patients with endoscopic reflux esophagitis were evaluated with a retrospective patient chart review.
  
  
  RESULTS
  A total of 1621 subjects underwent emergency endoscopy; 1420 of the endoscopies were because of hematemesis or melena. Endoscopic examination revealed that 19 cases with bleeding were caused by reflux esophagitis (19/1621, 1.2%). The 19 patients with bleeding and the four patients with stenosis (0.2%) had emergency endoscopy performed for complications of reflux esophagitis. The Los Angeles classification of these 23 cases showed that most were severe esophagitis (grade A, 0; B, 2; C, 8; and D, 13). The frequency of comorbidity with diabetes mellitus and collagen disease and the proportion of heavy drinkers were higher in patients who received emergency endoscopy because of reflux esophagitis than in those diagnosed with reflux esophagitis but who received emergency endoscopy because of other diseases.
  
  
  CONCLUSIONS
  Relatively small numbers of patients with reflux esophagitis undergo emergency endoscopy in Japan, and most such patients have underlying diseases, including diabetes mellitus and collagen disease. This finding is supported by a previous report that severe esophagitis is not common in Japan.
authors.affiliation: Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Iwakiri
authors.forename: Kanako
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mizuta
authors.forename: Ryo
authors.initials: R
authors.lastname: Shimoda
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Sakata
authors.forename: Akitaka
authors.initials: A
authors.lastname: Hisatomi
authors.forename: Masanobu
authors.initials: M
authors.lastname: Mizuguchi
authors.forename: Seiji
authors.initials: S
authors.lastname: Sato
authors.forename: Kohji
authors.initials: K
authors.lastname: Miyazaki
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
mesh_terms: D003937:Diagnosis, Differential; D004630:Emergencies; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004940:Esophageal Stenosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D004942:Esophagitis, Peptic / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index