Endoscopic diagnosis of gastric ulcer

Diagnóstico endoscópico de la úlcera gástrica

Sojo, Enrique - Estapé, Gonzalo - Falconi, Luis - De Los Santos, Julio - Suiffet, Walter

Resumen:

This paper reviews the author's experience in endoscopic diagnosis of gastric ulcers. Over a 5 - year period they performed over 5.000 fibroscopies in the study of 659 stomach ulcers, 29 rtéostomy ulcers and 82 pyloric ulcers.There follows an evaluation of the usefulness of this technique for the purpose of diagnosis, since it is highly effective in establishing the existence or abscence of gastric ulcerated lesions regardless of size, location or evolutive stage.Case material examined confirmed that the most frequent location is the 'esser gastric curvature. However, it differs from other statistics in pointing out that distribution was practically identical in the three thirds into which the vertical sector of the lesser curvature was divided. This difference is attributed to the difficulty in radiological diagnosis of ulcers in the infracardial region. It is also worth noting that a fifth of all ulcers were lodged in the surface, lesser antral curvature and greater curvature and biopsy proved that they were benign in nature. Therefore, diagnosis of the nature of a gastric ulceratedesion should not be based on its topography but rather in its macroscopic endoscopic aspect and in the obtention of material for histologic and cytologic study. Macroscopic differential diagnosis between ulcer and cancer in the different stages, is analyzed in detall.Evaluation of biopsy in small neoplasic lesions ( 28 superficial cancers), made possible the correct diagnosis of their nature in 27 cases ( 95 % positive diagnosis). Emphasis is laid on the need for an endoscopic examination of all gastric mucosa, in search of possible coexistent lesions, benign or neopasic ( 4 cases of associated ulcers and superficial neoplasm), as well as a duodenal examination, in view of the well - known association of this organ and ulcus.


El presente trabajo resume la experiencia de los autores, en el diagnóstico endoscópico de la úlcera gástrica. En el curso de 5 años realizaron más de 5.000 fibroscopías, estudiando 659 úlceras de estómago, 29 úlceras de neoboca y82 úlceras pilóricas.Analizan las nuevas posibilidade1 s diagnósticas que brinda esta técnica en cuanto a que posibilita establecer con alta efectividad, la existencia o no de una lesión ulcerada gástrica, sin importar su tamaño, localización o etapaevolutiva.En su casuística confirman que la localización más frecuente es la curvatura menor gástrica. Pero difieren con otras estadísticas, al señalar que la distribución fue casi idéntica en los tres tercios en que se dividió el sector vertical de la pequeña curva. Atribuyen esta diferencia a las dificultade, del diagnóstico radiológico en la úlcera de la región infracardial. Señalan también que casi una quinta parte deltotal de úlceras, asentaron en las caras, curvatura, menor antral y gran curva y la biopsia pudo demostrar que eran de naturaleza benigna.El diagnóstico de naturaleza de una lesión ulcerada gástrica no descansa pues en su topografía sino en su aspecto macroscópico endoscópico y la obtención de material para estudio histológico y citológico. El diagnóstico diferencialmacroscópico entre úlcera y cáncer en sus diversas etapas, es analizado pormenorizadamente.La evaluación de la biopsia en lesiones neoplásicas pequeñas (28 cánceres, superficiales) permitió el diagnóstico correcto de naturaleza en 27 (95 % de positividad).Se enfatiza la necesidad de un examen endoscópico de toda la mucosa gástrica, por la posibilidad de lesiones coexistentes, benignas o neoplásicas ( 4 casos de asociación de úlcera y neoplasma superficial) así como también del examen duodenal, por la conocida asociación con ulcus de este órgano.


Detalles Bibliográficos
1978
fibrogastroscopia
estómago
úlcera
fibergastroscopy
stomach
ulcer
Español
Sociedad de Cirugía del Uruguay
Revista Cirugía del Uruguay
https://revista.scu.org.uy/index.php/cir_urug/article/view/2983
Acceso abierto
Resumen:
Sumario:This paper reviews the author's experience in endoscopic diagnosis of gastric ulcers. Over a 5 - year period they performed over 5.000 fibroscopies in the study of 659 stomach ulcers, 29 rtéostomy ulcers and 82 pyloric ulcers.There follows an evaluation of the usefulness of this technique for the purpose of diagnosis, since it is highly effective in establishing the existence or abscence of gastric ulcerated lesions regardless of size, location or evolutive stage.Case material examined confirmed that the most frequent location is the 'esser gastric curvature. However, it differs from other statistics in pointing out that distribution was practically identical in the three thirds into which the vertical sector of the lesser curvature was divided. This difference is attributed to the difficulty in radiological diagnosis of ulcers in the infracardial region. It is also worth noting that a fifth of all ulcers were lodged in the surface, lesser antral curvature and greater curvature and biopsy proved that they were benign in nature. Therefore, diagnosis of the nature of a gastric ulceratedesion should not be based on its topography but rather in its macroscopic endoscopic aspect and in the obtention of material for histologic and cytologic study. Macroscopic differential diagnosis between ulcer and cancer in the different stages, is analyzed in detall.Evaluation of biopsy in small neoplasic lesions ( 28 superficial cancers), made possible the correct diagnosis of their nature in 27 cases ( 95 % positive diagnosis). Emphasis is laid on the need for an endoscopic examination of all gastric mucosa, in search of possible coexistent lesions, benign or neopasic ( 4 cases of associated ulcers and superficial neoplasm), as well as a duodenal examination, in view of the well - known association of this organ and ulcus.