Caratteristiche endoscopiche ed istopatologiche delle ulcere esofagee. Considerazioni su di una casistica di 13 pazienti.

Translated title of the contribution: Endoscopic & histopathologic features of esophageal ulcers. Considerations in 13 cases

G. Ressetta, F. Ziza, D. La Bruna, M. Cortale, M. Melato, S. Bucconi

Research output: Contribution to journalArticlepeer-review

Abstract

Chronic, severe reflux esophagitis can be complicated with an esophageal ulcer (EU), whose histomorphological characteristics change sensibly. Between 1983 and 1989, 18 EU were endoscopically identified in 13 (6%) out of 217 patients with chronic gastroesophageal reflux (GER). 2 groups were defined: EU and esophagitis, without columnar-lined esophagus and EU with localized columnar metaplasia or Barrett's esophagus. In the first, 4 Wolf's ulcers (WU) were present; in the second, there were 8 Barrett's ulcers (BU), 2 Savary's ulcers (SU) and 4 ulcers with intermediary characteristics (IU). The 24 h esophageal Ph monitoring demonstrated the reflux pathogenesis in all the patients (57%: alkaline reflux). The histomorphological findings of the EU could support the hypotesis that their variety is related to the different stage of the reflux disease. The EU, started as a peptic lesion on a stratified squamous mucosa (WU), due to an acid, alkaline or mixed reflux, would macroscopically turn into a BU, through intermediary entities (SU, IU), with a progressive extension of columnar metaplasia to the adjacent epithelium and walls. It's not possible to exclude the primitive development of the BU in a Barrett's mucosa, because of an alkaline reflux or because of a low mucosa's resistance (specialized columnar epithelium) to a prolonged acid exposure.

Translated title of the contributionEndoscopic & histopathologic features of esophageal ulcers. Considerations in 13 cases
Original languageItalian
JournalAnnali Italiani di Chirurgia
Volume66
Issue number6
Publication statusPublished - Nov 1995

ASJC Scopus subject areas

  • Surgery

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