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Endoscopic and histological study of gastric mucosa in liver cirrhosis with special reference to cases treated with endoscopic injection sclerotherapy for esophageal varices



Endoscopic and histological study of gastric mucosa in liver cirrhosis with special reference to cases treated with endoscopic injection sclerotherapy for esophageal varices



Gastroenterological Endoscopy 29(10): 2166-2178



The author studied endoscopic, histological and ultrastructural features of gastric mucosa in patients with liver cirrhosis. The morphological changes of the gastric mucosa was investigated in patients who had endoscopic injection sclerotherapy (EIS) for esophageal varices. The gastric mucosa in liver cirrhosis with esophageal varices was compared with that of normal controls and superficial gastritis. 1) Redness and edema were observed frequently on teh gastric mucosa in liver cirrhosis on endoscopic examination; Especially, linear reddening and petechial hemorrhage were usually found not only in patients with advanced esophageal varices, but also in patients one month postoperatively of EIS. 2) In microscopic and electronmicroscopic study, the redness of the gastric mucosa seen in liver cirrhosis was not associated with inflammatory process as seen in superficial gastritis but was produced by a marked dilatation of capillaries secondary to portal hypertension; Edema of the gastric mucosa in liver cirrhosis was noniflammatory and was due to transudation by an elevated intraluminal pressure of gastric capillaries secondary to portal hypertension. It is assumed that linear reddening is related to a marked dilatation of the capillaries and that petechial hemorrhage observed endoscopically is due to leakage of erythrocytes from the capillaries. 3) The result of this endoscopic study suggests that the presence of linear reddening and petechial hemorrhage of gastric mucosa in liver cirrhosis with hemorrhagic tendency is an ominous sign fo gastric bleeding which precipitates hepatic coma.

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Accession: 005359097

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