Studies on gastritis in the upper portion of stomach by congo-red test

Abstract

An endoscopical examination method of gastritis in upper portion of the stomach and the map of cardiac gland area was demonstrated by the congo-red test which indicates acid secreting function in detail, and their clinico-pathological studies were made by the biopsic specimen and/or resected stomach.
1) Histological survey on the 20 resected human stomach revealed that cardiac gland area was recognized in only 50%, and even in the 50%, cardiac glands were confined within extremely narrow area of which average was 2 mm from esophago-gastric junction, up to where the fundic gland area occupied in many instances.
2) By means of the congo-red test, extent of gastritis in upper portion of the stomach can be easily observed endoscopically as “non-discolored area” that has no acid secreting function. The pattern was divided into the following 3 types;
a: Whole sight around cardia is the discolored area by sound acid secretion for absence of gastritis.
b: Co-existence of discolored and non-discolored area by partially impaired acid secretion for partial gastritis.
c: Entire impairment of acid secretion due to pan-gastritis.
3) Histological findings in gastritis of the upper portion of the stomach were mainly atrophy of fundic glands and intestinal meta plasia. Epithelial defect, edem, infiltration of inflammatory cells and hyperemia were also seen.
4) In the way of gastritic extention, besides (1) from the lower corpus to the cardia, there is another way (2) that begins in the cardia and spreads to the lower.
5) Gastritis which begins from cardiac side, grows with aging, and the histological changes were advance of fundic glands' atrophy and intestinal metaplasia.