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Histological features of the gastric mucosa in children with primary bile reflux gastritis.

Zhang Y, Yang X, Gu W, Shu X, Zhang T, Jiang M - World J Surg Oncol (2012)

Bottom Line: The positive rate of pathological duodenogastric reflux was significantly higher in patients with foveolar hyperplasia than those without foveolar hyperplasia; however, the rate was significantly lower in patients with vascular congestion than those without vascular congestion.Foveolar hyperplasia and vascular congestion in the superficial layer became significant variables in the last step of the stepwise regression.Foveolar hyperplasia was associated with the severity of bile reflux, suggesting that it is a histological feature of primary BRG in children, while vascular congestion may be a protective factor.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine, Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Hangzhou 310003, P.R. China.

ABSTRACT

Background: Bile reflux is one of the primary factors involved in the pathogenesis of gastric mucosal lesions in patients with chronic gastritis; however, little is known about the exact histological features of bile reflux and its contributions to gastric mucosal lesions in this disease, especially in children with primary bile reflux gastritis (BRG). The aim of this study was to investigate the classic histological changes of the gastric mucosa in children with primary BRG.

Methods: The Bilitec 2000 was used for 24 h monitoring of gastric bile in 59 children with upper gastrointestinal symptoms. The histological characteristics of the gastric mucosa were examined and scored.

Results: Thirteen of the 59 patients had a helicobacter pylori infection and were excluded; therefore, 46 cases were included in this study. The positive rate of pathological duodenogastric reflux was significantly higher in patients with foveolar hyperplasia than those without foveolar hyperplasia; however, the rate was significantly lower in patients with vascular congestion than those without vascular congestion. The longest reflux time and the total percentage time of bile reflux were significantly lower in patients with vascular congestion than those without vascular congestion. A total of 9 types of histological changes were analyzed using a binary logistic regression. Foveolar hyperplasia and vascular congestion in the superficial layer became significant variables in the last step of the stepwise regression.

Conclusions: Foveolar hyperplasia was associated with the severity of bile reflux, suggesting that it is a histological feature of primary BRG in children, while vascular congestion may be a protective factor.

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Lymphatic follicle in the gastric mucosa in patients with bile reflux (HE staining, magnification 100×).
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Figure 1: Lymphatic follicle in the gastric mucosa in patients with bile reflux (HE staining, magnification 100×).

Mentions: Thirteen cases of 59 patients had HP infection; thus, according to the exclusion criteria, 46 patients were enrolled in this study. No gastric antral atrophy was found in these groups. The scores of different histological changes in the gastric antral mucosa and the parameters of bile reflux are shown in Table 1. Our results indicated that the longest reflux time and the total percentage time of bile reflux were significantly lower in cases with vascular congestion of the superficial mucosa than in those without vascular congestion [55(1-23) vs. 137(7-240), 22.8(0.9-55.1) vs. 35.2(3.5-82.8), respectively]. No significant differences in the bile reflux parameters were found for the other histological changes of the gastric mucosa. The gastric mucosal histological changes in patients with bile reflux are shown in Figure 1, 2, 3, 4, 5 and 6.


Histological features of the gastric mucosa in children with primary bile reflux gastritis.

Zhang Y, Yang X, Gu W, Shu X, Zhang T, Jiang M - World J Surg Oncol (2012)

Lymphatic follicle in the gastric mucosa in patients with bile reflux (HE staining, magnification 100×).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3278363&req=5

Figure 1: Lymphatic follicle in the gastric mucosa in patients with bile reflux (HE staining, magnification 100×).
Mentions: Thirteen cases of 59 patients had HP infection; thus, according to the exclusion criteria, 46 patients were enrolled in this study. No gastric antral atrophy was found in these groups. The scores of different histological changes in the gastric antral mucosa and the parameters of bile reflux are shown in Table 1. Our results indicated that the longest reflux time and the total percentage time of bile reflux were significantly lower in cases with vascular congestion of the superficial mucosa than in those without vascular congestion [55(1-23) vs. 137(7-240), 22.8(0.9-55.1) vs. 35.2(3.5-82.8), respectively]. No significant differences in the bile reflux parameters were found for the other histological changes of the gastric mucosa. The gastric mucosal histological changes in patients with bile reflux are shown in Figure 1, 2, 3, 4, 5 and 6.

Bottom Line: The positive rate of pathological duodenogastric reflux was significantly higher in patients with foveolar hyperplasia than those without foveolar hyperplasia; however, the rate was significantly lower in patients with vascular congestion than those without vascular congestion.Foveolar hyperplasia and vascular congestion in the superficial layer became significant variables in the last step of the stepwise regression.Foveolar hyperplasia was associated with the severity of bile reflux, suggesting that it is a histological feature of primary BRG in children, while vascular congestion may be a protective factor.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Gastroenterology, Children's Hospital, Zhejiang University School of Medicine, Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Hangzhou 310003, P.R. China.

ABSTRACT

Background: Bile reflux is one of the primary factors involved in the pathogenesis of gastric mucosal lesions in patients with chronic gastritis; however, little is known about the exact histological features of bile reflux and its contributions to gastric mucosal lesions in this disease, especially in children with primary bile reflux gastritis (BRG). The aim of this study was to investigate the classic histological changes of the gastric mucosa in children with primary BRG.

Methods: The Bilitec 2000 was used for 24 h monitoring of gastric bile in 59 children with upper gastrointestinal symptoms. The histological characteristics of the gastric mucosa were examined and scored.

Results: Thirteen of the 59 patients had a helicobacter pylori infection and were excluded; therefore, 46 cases were included in this study. The positive rate of pathological duodenogastric reflux was significantly higher in patients with foveolar hyperplasia than those without foveolar hyperplasia; however, the rate was significantly lower in patients with vascular congestion than those without vascular congestion. The longest reflux time and the total percentage time of bile reflux were significantly lower in patients with vascular congestion than those without vascular congestion. A total of 9 types of histological changes were analyzed using a binary logistic regression. Foveolar hyperplasia and vascular congestion in the superficial layer became significant variables in the last step of the stepwise regression.

Conclusions: Foveolar hyperplasia was associated with the severity of bile reflux, suggesting that it is a histological feature of primary BRG in children, while vascular congestion may be a protective factor.

Show MeSH
Related in: MedlinePlus