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New Endoscopic Indicator of Esophageal Achalasia: “Pinstripe Pattern”
BACKGROUND AND STUDY AIMS: Endoscopic diagnosis of esophageal achalasia lacking typical endoscopic features can be extremely difficult. The aim of this study was to identify simple and reliable early indicator of esophageal achalasia. PATIENTS AND METHODS: This single-center retrospective study incl...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321991/ https://www.ncbi.nlm.nih.gov/pubmed/25664812 http://dx.doi.org/10.1371/journal.pone.0101833 |
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author | Minami, Hitomi Isomoto, Hajime Miuma, Satoshi Kobayashi, Yasutoshi Yamaguchi, Naoyuki Urabe, Shigetoshi Matsushima, Kayoko Akazawa, Yuko Ohnita, Ken Takeshima, Fuminao Inoue, Haruhiro Nakao, Kazuhiko |
author_facet | Minami, Hitomi Isomoto, Hajime Miuma, Satoshi Kobayashi, Yasutoshi Yamaguchi, Naoyuki Urabe, Shigetoshi Matsushima, Kayoko Akazawa, Yuko Ohnita, Ken Takeshima, Fuminao Inoue, Haruhiro Nakao, Kazuhiko |
author_sort | Minami, Hitomi |
collection | PubMed |
description | BACKGROUND AND STUDY AIMS: Endoscopic diagnosis of esophageal achalasia lacking typical endoscopic features can be extremely difficult. The aim of this study was to identify simple and reliable early indicator of esophageal achalasia. PATIENTS AND METHODS: This single-center retrospective study included 56 cases of esophageal achalasia without previous treatment. As a control, 60 non-achalasia subjects including reflux esophagitis and superficial esophageal cancer were also included in this study. Endoscopic findings were evaluated according to Descriptive Rules for Achalasia of the Esophagus as follows: (1) esophageal dilatation, (2) abnormal retention of liquid and/or food, (3) whitish change of the mucosal surface, (4) functional stenosis of the esophago-gastric junction, and (5) abnormal contraction. Additionally, the presence of the longitudinal superficial wrinkles of esophageal mucosa, “pinstripe pattern (PSP)” was evaluated endoscopically. Then, inter-observer diagnostic agreement was assessed for each finding. RESULTS: The prevalence rates of the above-mentioned findings (1–5) were 41.1%, 41.1%, 16.1%, 94.6%, and 43.9%, respectively. PSP was observed in 60.7% of achalasia, while none of the control showed positivity for PSP. PSP was observed in 26 (62.5%) of 35 cases with shorter history < 10 years, which usually lacks typical findings such as severe esophageal dilation and tortuosity. Inter-observer agreement level was substantial for food/liquid remnant (k = 0.6861) and PSP (k = 0.6098), and was fair for abnormal contraction and white change. The accuracy, sensitivity, and specificity for achalasia were 83.8%, 64.7%, and 100%, respectively. CONCLUSION: “Pinstripe pattern” could be a reliable indicator for early discrimination of primary esophageal achalasia. |
format | Online Article Text |
id | pubmed-4321991 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-43219912015-02-18 New Endoscopic Indicator of Esophageal Achalasia: “Pinstripe Pattern” Minami, Hitomi Isomoto, Hajime Miuma, Satoshi Kobayashi, Yasutoshi Yamaguchi, Naoyuki Urabe, Shigetoshi Matsushima, Kayoko Akazawa, Yuko Ohnita, Ken Takeshima, Fuminao Inoue, Haruhiro Nakao, Kazuhiko PLoS One Research Article BACKGROUND AND STUDY AIMS: Endoscopic diagnosis of esophageal achalasia lacking typical endoscopic features can be extremely difficult. The aim of this study was to identify simple and reliable early indicator of esophageal achalasia. PATIENTS AND METHODS: This single-center retrospective study included 56 cases of esophageal achalasia without previous treatment. As a control, 60 non-achalasia subjects including reflux esophagitis and superficial esophageal cancer were also included in this study. Endoscopic findings were evaluated according to Descriptive Rules for Achalasia of the Esophagus as follows: (1) esophageal dilatation, (2) abnormal retention of liquid and/or food, (3) whitish change of the mucosal surface, (4) functional stenosis of the esophago-gastric junction, and (5) abnormal contraction. Additionally, the presence of the longitudinal superficial wrinkles of esophageal mucosa, “pinstripe pattern (PSP)” was evaluated endoscopically. Then, inter-observer diagnostic agreement was assessed for each finding. RESULTS: The prevalence rates of the above-mentioned findings (1–5) were 41.1%, 41.1%, 16.1%, 94.6%, and 43.9%, respectively. PSP was observed in 60.7% of achalasia, while none of the control showed positivity for PSP. PSP was observed in 26 (62.5%) of 35 cases with shorter history < 10 years, which usually lacks typical findings such as severe esophageal dilation and tortuosity. Inter-observer agreement level was substantial for food/liquid remnant (k = 0.6861) and PSP (k = 0.6098), and was fair for abnormal contraction and white change. The accuracy, sensitivity, and specificity for achalasia were 83.8%, 64.7%, and 100%, respectively. CONCLUSION: “Pinstripe pattern” could be a reliable indicator for early discrimination of primary esophageal achalasia. Public Library of Science 2015-02-09 /pmc/articles/PMC4321991/ /pubmed/25664812 http://dx.doi.org/10.1371/journal.pone.0101833 Text en © 2015 Minami et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Minami, Hitomi Isomoto, Hajime Miuma, Satoshi Kobayashi, Yasutoshi Yamaguchi, Naoyuki Urabe, Shigetoshi Matsushima, Kayoko Akazawa, Yuko Ohnita, Ken Takeshima, Fuminao Inoue, Haruhiro Nakao, Kazuhiko New Endoscopic Indicator of Esophageal Achalasia: “Pinstripe Pattern” |
title | New Endoscopic Indicator of Esophageal Achalasia: “Pinstripe Pattern” |
title_full | New Endoscopic Indicator of Esophageal Achalasia: “Pinstripe Pattern” |
title_fullStr | New Endoscopic Indicator of Esophageal Achalasia: “Pinstripe Pattern” |
title_full_unstemmed | New Endoscopic Indicator of Esophageal Achalasia: “Pinstripe Pattern” |
title_short | New Endoscopic Indicator of Esophageal Achalasia: “Pinstripe Pattern” |
title_sort | new endoscopic indicator of esophageal achalasia: “pinstripe pattern” |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321991/ https://www.ncbi.nlm.nih.gov/pubmed/25664812 http://dx.doi.org/10.1371/journal.pone.0101833 |
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