Endoscopically defined gastroesophageal junction coincides with the anatomical gastroesophageal junction

Wallner, Bengt

doi:10.1007/s00464-008-0238-9

Cited by 17 publications

(8 citation statements)

References 15 publications

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“…The second possible explanation was that the CS might be specifically performed at the EGJ region and its scope exactly represented the range of EGJ. The hypothesis, that EGJ was not a simple line, but a small portion of the lower esophagus to the cardia, was suggested by previous studies [ 22 – 24 ]. The dense squamous epithelium covering the EGJ might be the reason why we could less likely observe CS in the control group.…”

Section: Discussionmentioning

confidence: 97%

Circular stripes were more common in Barrett’s esophagus after acetic acid staining

Sun

Fang

et al. 2018

BMC Gastroenterol

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BackgroundThe diagnosis of Barrett’s esophagus (BE) is disturbed by numerous factors, including correct gastroesophageal junction judgment, the initial location of the Z-line and the biopsy result above it. The acetic acid (AA) could help to diagnose BE better than high resolution imaging technology or magnifying endoscopy, by providing enhanced contrast of different epithelium. We have noticed AA could produce multiple white circular lines, forming circular stripes (CS), at lower esophagus, which hasn’t been reported by others. This study aimed to investigate whether the CS is a special marker in BE patients.MethodsA total of 47 BE patients and 63 healthy people were enrolled from March 2016 to October 2016, and 2% AA staining had been operated routinely at lower esophagus under high resolution gastroscopy. We observed whether there were CS after AA staining and the images were compared between the two groups.ResultsCS were confirmed in 42 patients (89.36%) in the BE group and 5 (7.94) in the control group ((χ2 = 72.931, P < 0.001)). The average width of CS was 0.76 ± 0.25 cm in BE group, which was similar to that in the control group (0.88 ± 0.11 cm). Villous or punctate or reticular pattern usually existed above or below the CS.ConclusionsCS could be found at lower esophagus in most BE patients with AA staining, and this special feature might be valuable in diagnosing, evaluating and following up of BE patients.Electronic supplementary materialThe online version of this article (10.1186/s12876-018-0745-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 97%

Circular stripes were more common in Barrett’s esophagus after acetic acid staining

Sun

Fang

et al. 2018

BMC Gastroenterol

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“…The EGDs were performed according to a strict protocol. The gastroesophageal junction (GEJ) was defined as the proximal margin of the gastric mucosal folds [19]. Esophagitis was classified according to the LA-classification [20].…”

Section: Endoscopymentioning

confidence: 99%

Z-line alterations and gastroesophageal reflux: an endoscopic population-based prospective cohort study

Wallner

Björ

Andréasson

et al. 2019

Scandinavian Journal of Gastroenterology

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Background and study aims: Barrett's esophagus is a premalignant condition in the distal esophagus associated with esophageal adenocarcinoma. Since gastroesophageal reflux is known to be of etiological importance in both Barrett's esophagus and esophageal adenocarcinoma, we aimed to study which endoscopic alterations at the Z-line can be attributed to a previous history of reflux symptoms. Patients and methods: From 1988, a population cohort in Sweden has been prospectively studied regarding gastrointestinal symptoms, using a validated questionnaire. In 2012, the population was invited to undergo a gastroscopy and participate in the present study. In order to determine which endoscopic alterations that can be attributed to a previous history of gastroesophageal reflux, three different endoscopic definitions of columnar-lined esophagus (CLE) were used: (1) ZAP I, An irregular Z-line with a suspicion of tongue-like protrusions; (2) ZAP II/III, Distinct, obvious tongues of metaplastic columnar epithelium; (3) CLE 1 cm, The Prague C/M-classification with a minimum length of 1 cm. Results: A total of 165 community subjects were included in the study. Of these, 40 had CLE 1 cm, 99 had ZAP I, and 26 had ZAP II/III. ZAP II/III was associated with an over threefold risk of previous GER symptoms (OR: 3.60, CI: 1.49-8.70). No association was found between gastroesophageal reflux and ZAP I (OR: 2.06, CI: 0.85-5.00), or CLE 1 cm (OR: 1.64, CI: 0.77-3.49). Conclusions: In a general community, the only endoscopic alteration to the Z-line definitely linked to longstanding GER symptoms was the presence of obvious tongues of metaplastic columnar epithelium (ZAP II/III).

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“…The length of any sliding hiatal hernia was defined as the discrepancy between these two measurements. The GEJ was defined as the proximal margin of the gastric mucosal folds [16]. The hiatus was defined as the level of the diaphragmatic pitch.…”

Section: Endoscopymentioning

confidence: 99%

Identifying clinically relevant sliding hiatal hernias: a population-based endoscopy study

Wallner

Björ

Andréasson

et al. 2018

Scandinavian Journal of Gastroenterology

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Endoscopically defined gastroesophageal junction coincides with the anatomical gastroesophageal junction

Abstract: The upper margin of the longitudinal folds of the stomach can be used as an appropriate endoscopic definition of the gastroesophageal junction.

Cited by 17 publications

References 15 publications

Circular stripes were more common in Barrett’s esophagus after acetic acid staining

Circular stripes were more common in Barrett’s esophagus after acetic acid staining

Z-line alterations and gastroesophageal reflux: an endoscopic population-based prospective cohort study

Identifying clinically relevant sliding hiatal hernias: a population-based endoscopy study

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