Do Won Choi

Endoscopically Observed Lower Esophageal Capillary Patterns

Background It has been reported that there are four zones of distinct venous patterns around the gastroesophageal junction (GEJ): i.e. truncal, perforating, palisade (PZ) and gastric zones. Using the distal end of PZ as a marker for GEJ, this study was done to assess the length and patterns of PZ in Koreans, and to assess the prevalence of endoscopic Barrett’s esophagus (E-BE) and hiatal hernia (E-HH). Methods: 847 consecutive patients undergoing diagnostic endoscopy were included. During endoscopy, PZ, squamocolumnar junction (SCJ) and pinchcock action (PCA) were identified. Patterns were classified according to the relationships of the distal end of PZ with SCJ and PCA; A: all three at the same level, B: SCJ proximal to the other two which are at the same level, C: PCA distal to the other two which are at the same level, D: SCJ proximal to the distal end of PZ which is proximal to PCA. Cases with patterns B and D were thought to have E-BE, and those with patterns C and D to have E-HH. Results: Patterns A, B, C and D were 79.2%, 12.1%, 3.8% and 4.9%, respectively. Length of PZ was 3.0±0.1cm. E-BE and E-HH were found in 17.0% and 8.7%, respectively. Both E-BE and E-HH were more frequently found in males and in cases with reflux esophagitis. Conclusion: E-BE and E-HH are not so infrequent in Koreans as previously thought, if we use the distal end of PZ as an endoscopic marker of GEJ.

P47 Endosocopic findings at bthe gastro-esophageal junction in Korea

mucosa. However, most of them were very short and the average maximum length of them was about 5mm. Although positions of proper esophageal glands were various patterns, all of lowest proper esophageal glands existed on the oral side of LEPV. Discussion: The fact of existence of CLE in almost cases investigated after esophagectomy means the possibility that almost patients might be diagnosed as having CLE or Barrett’s mucosa in the precise endoscopic observation in Japan. If the clinical diagnosis of CLE is made by Japanese criteria anatomically, a part of CLE, e.g. less than 5mm in length, should be excluded as within normal range and the criteria of short segment Barrett’s esophagus (SSBE) should be distinguished because the definition of SSBE may fall into more confusion. The fact that lowest proper esophageal glands did’not exist on the anal side of LEPV indicate that esophagogastric junction may be defined by LEPV.