Abstract
We found subepithelial longitudinal vessels at the lower esophagus in all 844 cases but 21 cases in which we could not find them because of mucosal thickening by inflammation. We measured endoscopically their length by using the silk thread marked at intervals of 5 mm, then 90% of them ranged from 2 cm to 3 cm. The "indentation", which corresponded to the angle of His, was observed at the junction with the tubular esophagus and the saccular stomach by both radiological and endoscopical examination. We made the investigation on positional relationship between the "indentation", squamo-columnar junction, and longitudinal vessels. We found no cases in which the longitudinal vessels were observed under the gastric mucosa beyond the "indentation". Therefore it is the finding peculiar to the esophagus to be able to observe subepithelial longitudinal vessels in the vicinity of the esophago-gastric junction. On 21.4% of 884 cases, longitudinal vessels were found under the columnar epithelium at the oral side over the "indentation" from the stomach. This columnar epithlium located at the esophagus because the longitudinal vessels were observed only at the esophagus, therefore it should be the Barrett's epithelium. Thus the definite diagnosis of the Barrett's epithelium can be made by endoscopic examination.
