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endoscopic fndings koreaendoscopic findings korea.doc

Endoscopic findings around the gastroesophageal junction: an experience from a tertiary hospital in Korea Ji Hyun Kim, M.D.,2 Jin Ki Hwang, M.D.,1 Juhyung Kim, M.D.,1 Sehe Dong Lee, M.D.,1 Beom Jae Lee, M.D.,1 Jae Seon Kim, M.D.,1 and Young-Tae Bak, M.D.1 1Department of Gastroenterology, Korea University Guro Hospital, Seoul, Korea. 2Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea. Corresponding author. Correspondence to: Young-Tae Bak, M.D., Department of Gastroenterology, Korea University Guro Hospital, 97 Gurodong-gil, Guro-gu, Seoul 152-703, Korea. Tel: 82-2-2626-1778, Fax: 82-505-115-1778,Email: drbakyt@korea.ac.kr Received February 9, 2008; Accepted June 16, 2008. Top Abstract INTRODUCTION MATERIALS AND METHODS RESULTS DISCUSSION References Abstract Background/Aims Important lesions related to gastroesophageal reflux disease (GERD) are located around the gastroesophageal junction (GEJ). This study examined the distribution of endoscopic findings around the GEJ and elucidated their relationship to each other and esophageal manometric features. Methods Endoscopic data were collected prospectively from 2,450 consecutive diagnostic upper gastrointestinal endoscopies. The presence and degree of hiatal hernia (HH), columnar-lined esophagus (CLE), and reflux esophagitis (RE) were recorded. Esophageal manometric data were collected from 181 patients. Results The prevalence of HH, CLE, and RE was 9.8, 18.8, and 9.9%, respectively. Of all HH and CLE cases, 62.8 and 98.9%, respectively, were of the short-segment variety. Of all RE cases, 95.0% were mild. Younger age, male gender, the presence of HH, and a higher gastroesophageal flap valve (GEFV) grades were associated with the presence of RE. Increased ZAP grades were associated with increased prevalence and grades of HH, CLE, and RE. Higher GEFV grades were associated with increased prevalence and grades of HH, CLE, and RE. Lower esophageal sphincter pressure (LESP) decreased in pati

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