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Clinical features of acute esophageal mucosal lesions and reflux esophagitis Los Angeles classification grade D: A retrospective study
BACKGROUND: Acute esophageal mucosal lesions (AEMLs) are an underrecognized and largely unexplored disease. Endoscopic findings are similar, and a higher percentage of AEML could be misdiagnosed as reflux esophagitis Los Angeles classification grade D (RE-D). These diseases could have different path...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080596/ https://www.ncbi.nlm.nih.gov/pubmed/37032792 http://dx.doi.org/10.4240/wjgs.v15.i3.408 |
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author | Ichita, Chikamasa Sasaki, Akiko Shimizu, Sayuri |
author_facet | Ichita, Chikamasa Sasaki, Akiko Shimizu, Sayuri |
author_sort | Ichita, Chikamasa |
collection | PubMed |
description | BACKGROUND: Acute esophageal mucosal lesions (AEMLs) are an underrecognized and largely unexplored disease. Endoscopic findings are similar, and a higher percentage of AEML could be misdiagnosed as reflux esophagitis Los Angeles classification grade D (RE-D). These diseases could have different pathologies and require different treatments. AIM: To compare AEML and RE-D to confirm that the two diseases are different from each other and to clarify the clinical features of AEML. METHODS: We selected emergency endoscopic cases of upper gastrointestinal bleeding with circumferential esophageal mucosal injury and classified them into AEML and RE-D groups according to the mucosal injury’s shape on the oral side. We examined patient background, blood sampling data, comorbidities at onset, endoscopic characteristics, and outcomes in each group. RESULTS: Among the emergency cases, the AEML and RE-D groups had 105 (3.1%) and 48 (1.4%) cases, respectively. Multiple variables exhibited significantly different results, indicating that these two diseases are distinct. The clinical features of AEML consisted of more comorbidities [risk ratio (RR): 3.10; 95% confidence interval (CI): 1.68–5.71; P < 0.001] and less endoscopic hemostasis compared with RE-D (RR: 0.25; 95%CI: 0.10–0.63; P < 0.001). Mortality during hospitalization was higher in the AEML group (RR: 3.43; 95%CI: 0.82–14.40; P = 0.094), and stenosis developed only in the AEML group. CONCLUSION: AEML and RE-D were clearly distinct diseases with different clinical features. AEML may be more common than assumed, and the potential for its presence should be taken into account in cases of upper gastrointestinal bleeding with comorbidities. |
format | Online Article Text |
id | pubmed-10080596 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-100805962023-04-08 Clinical features of acute esophageal mucosal lesions and reflux esophagitis Los Angeles classification grade D: A retrospective study Ichita, Chikamasa Sasaki, Akiko Shimizu, Sayuri World J Gastrointest Surg Retrospective Study BACKGROUND: Acute esophageal mucosal lesions (AEMLs) are an underrecognized and largely unexplored disease. Endoscopic findings are similar, and a higher percentage of AEML could be misdiagnosed as reflux esophagitis Los Angeles classification grade D (RE-D). These diseases could have different pathologies and require different treatments. AIM: To compare AEML and RE-D to confirm that the two diseases are different from each other and to clarify the clinical features of AEML. METHODS: We selected emergency endoscopic cases of upper gastrointestinal bleeding with circumferential esophageal mucosal injury and classified them into AEML and RE-D groups according to the mucosal injury’s shape on the oral side. We examined patient background, blood sampling data, comorbidities at onset, endoscopic characteristics, and outcomes in each group. RESULTS: Among the emergency cases, the AEML and RE-D groups had 105 (3.1%) and 48 (1.4%) cases, respectively. Multiple variables exhibited significantly different results, indicating that these two diseases are distinct. The clinical features of AEML consisted of more comorbidities [risk ratio (RR): 3.10; 95% confidence interval (CI): 1.68–5.71; P < 0.001] and less endoscopic hemostasis compared with RE-D (RR: 0.25; 95%CI: 0.10–0.63; P < 0.001). Mortality during hospitalization was higher in the AEML group (RR: 3.43; 95%CI: 0.82–14.40; P = 0.094), and stenosis developed only in the AEML group. CONCLUSION: AEML and RE-D were clearly distinct diseases with different clinical features. AEML may be more common than assumed, and the potential for its presence should be taken into account in cases of upper gastrointestinal bleeding with comorbidities. Baishideng Publishing Group Inc 2023-03-27 2023-03-27 /pmc/articles/PMC10080596/ /pubmed/37032792 http://dx.doi.org/10.4240/wjgs.v15.i3.408 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/ |
spellingShingle | Retrospective Study Ichita, Chikamasa Sasaki, Akiko Shimizu, Sayuri Clinical features of acute esophageal mucosal lesions and reflux esophagitis Los Angeles classification grade D: A retrospective study |
title | Clinical features of acute esophageal mucosal lesions and reflux esophagitis Los Angeles classification grade D: A retrospective study |
title_full | Clinical features of acute esophageal mucosal lesions and reflux esophagitis Los Angeles classification grade D: A retrospective study |
title_fullStr | Clinical features of acute esophageal mucosal lesions and reflux esophagitis Los Angeles classification grade D: A retrospective study |
title_full_unstemmed | Clinical features of acute esophageal mucosal lesions and reflux esophagitis Los Angeles classification grade D: A retrospective study |
title_short | Clinical features of acute esophageal mucosal lesions and reflux esophagitis Los Angeles classification grade D: A retrospective study |
title_sort | clinical features of acute esophageal mucosal lesions and reflux esophagitis los angeles classification grade d: a retrospective study |
topic | Retrospective Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080596/ https://www.ncbi.nlm.nih.gov/pubmed/37032792 http://dx.doi.org/10.4240/wjgs.v15.i3.408 |
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