A Study in the Diagnosis of Gastric Lesions Using the Fibergastroscope

Abstract

The fibergastroscope, thanks to its great flexibility, has proved to be invaluable in the diagnosis of Gastric Suffering. This report concerns a new approach in diagnosis, whereby the visibility and features of the mucosal surface are enhanced by surface staining of the gastric lesions under observation with a solution of 0.4% Coomassie Blue and 0.6%Evans Blue. With this new staining process, changes involving mucosal unevenness or fine pathological irregularities are contrasted against the gastric surface, so that the resulting photographs are far clearer than those obtained in the process ordinarily used at present. Fibergastroscopes of the K and C types made by the Machida Co. in Tokyo, Japan, have been used in this new procedure. These fibergastroscopes contain two tubes : air is injected through one, and water through the other. In this new procedure, however, a dye solution has been used instead of water, and the staining process can be observed and photographs taken at the same time. Since February 1966, 750 cases of gastric cancers, ulcers, ulcer scars, polyps, etc., have been examined with the fibergastroscope. They have been submitted first to routine observation and photographing, then to surface staining, observed again and recorded. As a result of these experiments, gastritis also can be diagnosed easily with this new procedure. For the whole gastric area concerned can be observed clearly, even down to munute changes of the gastric mucosal surface. In the case of protruding lesions (cancers, po lyps, etc.), for example, the shape and features of their surface, as well as the usually undetectable portions around the base, are perfectly clear. Again, the circumf arence of an ulcer, as well as modifications in the surrounding areas, slight depressions within mucosal lesions, various forms of gastric folds and their delicate variations at the area of convergence, all can be seen clearly. Thus, this new staining procedure should be of great service in differential diagnosis for benignancy and malignancy, as well as in determining the degree of malignancy. Finally, this procedure is absolutely safe and can be employed quickly and easily.