The Effect of Intragastric Pressure on the Endoscopic Findings of the Chronic Gastritis

Abstract

The distension of the gastric wall gas great influence on the endoscopic appearance of the chronic gastritis. The aim of this investigation is to analyze the fundamental relation between them.
The author believed that the tension of the gastric wall would be reflected more correctly by the intragastric pressure than by the insufflated volume of the air. The endoscopic findings, such as mucosal visible vessels, flat elevation of the intestinal metaplasia and thickness of the gigantic folds, were analyzed dynamically in relation to the changes of the intragastric pressure by the help of a manometric recorder.
As the result, intragastric pressure showed liniar co-relation to the insufflated volume of the air in every case.
The visualization of the mucosal vessels were conventionally classified into three groups. A-1; visual vessels with the pressure more than 10mmHg. A-2; visualization within the pressure 5-10mmHg. A-3; visualization only below 5mmHg. The histological investigation through biopsy was also carried out to evaluate the grade of atrophy.
The influence of intragastric pressure on the appearance of the flat elevation of intestinal metaplasia was classified into three grades. D-1; visualizztion of this elevation with the pressure below 15mmHg. D-2; visualization within the pressure 15-20mmHg. D-3; visualization with the pressure even more than 20mmHg. Histological confirmation of metaplasia was done by biopsy.
The groping of the gigantic folds were as follows: F-1; complete flattening of folds within the pressure of 15mmHg. F-2; incomplete but noticable flattening of the folds with the pressure more than 15mmHg. F-3; maintenance of initial thickness of folds with maximum tolerant pressure. Only this F-3 would be regarded as real"giant rugae".
In conclusion, the effect of the intragastric pressure should always be borne in mind during the endoscopic diagnosis of chronic gastritis.