title: The significance of gastric and duodenal histological ischemia reported on endoscopic biopsy.
abstract: Although frequently reported, it is unknown whether pathological reports of ischemia obtained from gastroduodenal biopsies suggest a diagnosis, prognosis or a requirement for additional evaluation. The aim of this study was to review the natural history, clinical presentation, endoscopic appearance, treatments, and major clinical outcomes of patients with gastroduodenal ischemia. A case series of 14 patients with variable etiologies (seven gastric and seven duodenal) was obtained from a search of our endoscopic pathological database for reports of histological ischemia. The results were as follows. The most common presentation was upper gastrointestinal bleeding (71 %). Half of the endoscopic lesions appeared very severe (large or circumferential lesions, exudative, pseudomembranous, black or pale mucosa). There were six cases of rebleeding (43 %) and four deaths (29 %). Computed tomography scanning was frequently used (12 cases, 86 %), but led to an underlying diagnosis in only three cases. In our series, patients with underlying vascular pathology have substantial 6-month mortality (29 %).
authors.affiliation: Center of Ulcer Research and Education, Digestive Diseases Research Center, Los Angeles, California, USA.
authors.forename: J
authors.initials: J
authors.lastname: Herman
authors.forename: D
authors.initials: D
authors.lastname: Chavalitdhamrong
authors.forename: D M
authors.initials: DM
authors.lastname: Jensen
authors.forename: G
authors.initials: G
authors.lastname: Cortina
authors.forename: A
authors.initials: A
authors.lastname: Manuyakorn
authors.forename: R
authors.initials: R
authors.lastname: Jutabha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D004386:Duodenum / Q000098:blood supply / Q000473:pathology*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000098:blood supply / Q000473:pathology*