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Endoscopic differential diagnosis of reflux esophagitis

Endoscopic differential diagnosis of reflux esophagitis

Stomach & Intestine 18(11): 1167-1173

Panendoscopy provides an opportunity to examine the human GE (gastroesophageal) junction and the esophagus. The endoscopic dye method has made it easier to recognize Z-line and improved the diagnostic ability of lesions around the GE junction. Many lesions cannot be diagnosed as reflux esophagitis and it is necessary to combine several tests, e.g., esophageal manometry, pH monitoring, gastrin tolerance test and acid perfusion test, to define their causes. In regards to the differential diagnosis of lower esophageal lesions, gastric carcinoma and esophageal carcinoma are the most important. The incidence of these lesions is low but gastric carcinoma can be easily diagnosed because it induces swelling of the gastric epithelium and makes its recognition easier. It is also rare to have localized squamous cell carcinoma around the Z-line, but it can be diagnosed by endoscopic Lugol-staining method even if routine endoscopy shows no significant abnormalities.

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Accession: 005359201

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