CLINICO-ENDOSCOPIC AND MORPHOLOGICAL FEATURES OF CHRONIC GASTRIC EROSIONS

A.G . BESSONOV, A.E. SHKLYAYEV, Y.L BAJENOV, G.I.KIRSHIN

Izhevsk State Medical Academy, Izhevsk, RUSSIA

Purpose. A study of clinico-endoscopic and morphological pattern in patients with chronic erosive lesions of the stomach.

Materials and methods of study. For the assessment of morpho-endoscopic data there were analyzed results of fibrogastroduodenoscopies in 128 patients with chronic gastric erosions (CGE). 38.3% were men, 61.7%- women. All patients were performed esophagogastroduodenoscopy (EGD) with target biopsy of gastric mucosa (two biopsy samples from the gastric body and one - from the antrum). Contamination with Helicobacter pylori (HP) was assessed by using the “gold standard”. The urease method (Campi-test, strips test and HELPIL test) and morphological staining by Giemsa (hematoxylin + eosin) was applied.

The results of the study. In both men and women dominated chronic erosion 53,7 ± 5,4% and 57,9 ± 3,7%, respectively, with the duration of disease for more than three years. A direct moderate relationship (r = 0,61) between the age and the incidence of erosive lesions of the stomach was revealed. HP - was found in 68,8 ± 4,4% of men and 80,2 ± 3,1% of women. The highest incidence of infection was observed almost equally in men 54,5 ± 2,3%, and women 75,3 ± 2,1% at age from 40 to 69 years. All women at old age had HP-infection. In EGDS conducted in 122 patients (95.1%) CGE were located in antrum. They had a rounded shape and were presented as raised section of mucosa with cone impression in the center. 44 patients (34.4%) had round ulcerations on the top. Isolated erosions were observed in 57% of patients, but in other cases there were revealed multiple CGE. The metaplastic signs in the histological pattern were obseved in 20,8 ± 8,9% of men and 14,3 ± 8,2% of women. Concomitant atrophic gastritis was diagnosed more often in men at the age of 36,7 ± 6,8 years, and women –at the age of 55,3 ± 6,7 years. In 95 (74.5%) patients CGE manifested with pains in the epigastric area with different degree of severity, including ulcer-like, in 56.7%. Dyspeptic complaints likem of nausea, heartburns, regurgitation were observed occurred in 80.1% of patients.

Thus, endoscopic, morphological, sex and age characteristics shall be considered in the choice of therapeutic interventions for patients with CGE. CGE does not have the typical clinical picture, and often occur against a background of atrophy or intestinal metaplasia in the presence of HP.

Date: 2014-12-28; view: 948