Difference in localization of esophageal mucosal breaks among grades of esophagitis

• DOI: 10.1111/j.1440-1746.2006.04297.x
• Publication Date: 2006-04-21T01:27:58Z
• Authors: Tomoko Katsube; Kyoichi Adachi; Kenji Furuta; Masaharu Miki; Tomoo Fujisawa; Takane Azumi; Yoshinori Kushiyama; Hideaki Kazumori; Shunji Ishihara; Yuji Amano; Yoshikazu Kinoshita
• Keywords: Male; Chi-Square Distribution; Mucous Membrane; Middle Aged; Statistics, Nonparametric; 03 medical and health sciences; Hernia, Hiatal; 0302 clinical medicine; Japan; Gastroesophageal Reflux; Prevalence; Esophagitis; Humans; Female; Esophagoscopy; Aged

AbstractBackground: 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.