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Back to 2014 Annual Meeting Posters
Upper Endoscopy and Barrett's Esophagus: Back to Basics
Bernardo Borraez*1, Marco E. Allaix1, Vani J. Konda2, Matthew Stier2, Robert T. Kavitt2, Gabriel Lang2, Marco G. Patti1
1General Surgery, University of Chicago, Chicago, IL; 2Medicine, University of Chicago, Chicago, IL
Background: Endoscopy is the key test for the diagnosis of Barrett Esophagus (BE). The diagnosis is based on the visualization of salmon colored mucosa on the background of the squamous epithelium, and on properly executed biopsies for pathologic confirmation.
Aims The aims of this study were to determine: (a) the sensitivity of visual inspection for the diagnosis of BE as compared to the pathology results; and (b) how often a proper description of the BE was done.
Methods: Review of a prospectively set database. We evaluated the endoscopic findings of 243 patients in whom the endoscopist thought that BE was present and compared them to the pathology results. In addition, we assessed how often the suspected BE was described and the proper biopsy protocol followed.
Results: The presence of BE was confirmed in 93 of the 243 patients (38.3%). Metaplasia was present in 88.2% and low grade dysplasia in 11.8%. The length of the segment was described in 68.3% of patients (63.4% short segment and 4.9% long segment). In 31.7% of patients the endoscopist thought that BE was present but no description was given. An average of 3.5+2.3 biopsies were taken.
Conclusions: The results of this study showed that: (a) the visual inspection for the diagnosis of BE had a low sensitivity; (b) a proper description of the BE was not done in 1/3 of patients. This study suggests the need for more strict observation of the AGA guidelines by physicians performing upper endoscopy.
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