Servikal özofagusta heterotopik gastrik mukoza "inlet patch": klinik, manometrik ve ph metrik özellikler
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Dosyalar
Tarih
2008
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Heterotopik gastrik mukoza (HGM), proksimal özofagusta yer alan sarımsı pembe renkte, çevre mukozadan keskin bir sınırla ayrılan renkli adacıklardır.Amaç: Heterotopik gastrik mukoza saptadığımız hastaların klinik özelliklerini, özofagus motor fonksiyonlarını ve pH profillerini araştırmak ve HGM'nin bu parametreler üzerine olan olası etkilerini saptamaktı.Gereç ve Yöntemler: Heterotopik gastrik mukoza saptanan 30 hasta çalışmaya alındı. Hastalar reflü belirti sorgulamasına göre reflü pozitif ve reflü negatif 2 gruba ayrıldı. Tüm hastalara özofagus manometre testi ve çift kanal pH probu ile 24 saat ambulatuvar pH ölçümü uygulandı.Bulgular: Otuz servikal HGM' li hasta reflü belirti sorgulamasına göre 18 (%60)'i reflü pozitif ve 12 (%40)'si reflü negatif olarak değerlendirildi. Hastaların belirti sorgulamalarında: Disfaji (%30), globus histerikus (% 40), ağza acı su gelmesi (%60), kronik öksürük (%26), kısık ses (%10), ağız kokusu (%40), boğazı temizleme hissi (%53), >6 ay devam eden boğaz ağrısı (%20), horlama (%40), dilde yanma (%16), gece apneleri (%0), sabah ses kısıklığı (%33) oranlarında saptandı. Reflü semptomu olan HGM'li vakalarda disfaji (%44.4'e karşılık %8.3; p=0.04), boğaz ağrısı (%33.3'e karşılık 0; p=0.031) ve sabah ses kısıklığı (%50'ye karşılık %8.3; p=0.021) mevcuttu. Olguların 4'ünde distal pH metrede asit reflü bulguları saptandı. Bu 4 olgunun 3 ünde proksimalde asit reflüsü bulgusu mevcuttu. Hiçbir hastada proksimalde, distalden bağımsız asit reflü atağı saptanmadı. Hiçbir hastada özofagus motor fonksiyon bozukluğu izlenmedi.Sonuç: Heterotopik gastrik mukoza birçok olguda gastroözofageal reflü hastalığının supraözofageal bulguları ile ortaya çıkabilmektedir. Heterotopik gastrik mukozanın salgıladığı az miktardaki asidin reflü semptomları üzerinde katkısı yoktur. Heterotopik gastrik mukoza özofagusda motor fonksiyon ve asit reflü parameterleri bozukluğuna yol açmayan iyi huylu bir lezyondur.
Background: Heterotopic gastric mucosa (HGM) in proximal oesophagus is yellowish-pink mucosal islands separated from normal mucosa with a sharp border.Aim: To determine clinical characteristics, oesophageal motor functions and pH profiles of the patients with HGM and to evaluate the possible effect of HGM on these entities.Material and Methods: Thirty patients with HGM were included in this study. Patients were divided in to 2 groups according to the reflux symptom scoring: reflux positive and reflux negative. Oesophagus manometry and 24-h double- channel pH metry were performed to all patients.Results: Eighteen (60%) and 12 (%40) patients were reflux positive and negative, respectly. According to the reflux symptom scoring, symptoms in HGM patients were as follows: dysphagia (30%), globus sensation (40%), regurgitation (60%), chronic cough (26%), hoarseness (10%), halitosis (40%), throat clearing (53%), sore throat >6 month (20%), snore (40%), glossodynia (16%), nocturnal apne (0%), morning hoarseness (33%). Statistical significance was found in HGM cases with reflux symptom about dysphagia (%44.4 vs. %8.3; p=0.04), sore throat (%33.3 vs. 0; p=0.031) and morning hoarseness (%50 vs. %8.3; p=0.021). Acid reflux findings were determined with distal pH metry in 4 patients. In 3 of these cases showed abnormal proximal acid reflux. None of these reflux episodes were in the form of isolated proximal reflux. None of the patients showed oesophageal motor dysfunction.Conclusion: In general HGM can be presented as supraesophageal symptoms of gastroesophageal reflux disease. Low acid secretion of HGM had no contributor effect on reflux symptoms. We believe that HGM in oesophagus is a benign lesion having no distribution effect on oesophagus motor function and acid reflux parameters.
Background: Heterotopic gastric mucosa (HGM) in proximal oesophagus is yellowish-pink mucosal islands separated from normal mucosa with a sharp border.Aim: To determine clinical characteristics, oesophageal motor functions and pH profiles of the patients with HGM and to evaluate the possible effect of HGM on these entities.Material and Methods: Thirty patients with HGM were included in this study. Patients were divided in to 2 groups according to the reflux symptom scoring: reflux positive and reflux negative. Oesophagus manometry and 24-h double- channel pH metry were performed to all patients.Results: Eighteen (60%) and 12 (%40) patients were reflux positive and negative, respectly. According to the reflux symptom scoring, symptoms in HGM patients were as follows: dysphagia (30%), globus sensation (40%), regurgitation (60%), chronic cough (26%), hoarseness (10%), halitosis (40%), throat clearing (53%), sore throat >6 month (20%), snore (40%), glossodynia (16%), nocturnal apne (0%), morning hoarseness (33%). Statistical significance was found in HGM cases with reflux symptom about dysphagia (%44.4 vs. %8.3; p=0.04), sore throat (%33.3 vs. 0; p=0.031) and morning hoarseness (%50 vs. %8.3; p=0.021). Acid reflux findings were determined with distal pH metry in 4 patients. In 3 of these cases showed abnormal proximal acid reflux. None of these reflux episodes were in the form of isolated proximal reflux. None of the patients showed oesophageal motor dysfunction.Conclusion: In general HGM can be presented as supraesophageal symptoms of gastroesophageal reflux disease. Low acid secretion of HGM had no contributor effect on reflux symptoms. We believe that HGM in oesophagus is a benign lesion having no distribution effect on oesophagus motor function and acid reflux parameters.
Açıklama
YÖK Tez No: 196192
Anahtar Kelimeler
Gastroenteroloji, Gastroenterology, Servikal inlet patch, gastro özofageal reflü, pH ölçümü, Özofagus manometri, Heterotopic gastric mucosa, gastroesophageal reflux, pH-monitoring, oesophagus manometry
