An experimental study of reflux esophagitis due to acid

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概要

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• Many clinical and experimental studies on reflux esophagitis have been reported. However, no definite diagnostic criteria or classification has been determined.This study was undertaken to determine a diagnostic criteria of acid reflux esophagitis based on experimentally induced esophagitis by various operative procedures and histamine administration in dogs.Materials and methods:Thirty three mongrel dogs were divided into three groups according to operative proceduresThirty three mongrel dogs were divided into three groups according to operative procedures. (Cardiectomy, Wendel operation, and Heyrovsky operation) All dogs were also divided in two groups whether if histamine was administered or not. Five dogs were injected only histamine of the same dosis and the administration method without any type of operation.Endoscopic examination, intraluminal pressure measurement with pH measurement using Beckman stomach glass electrode, cinefluorographic observation was performed before and after operation.After autopsy, precise observations of the gross specimens of the esophagus were done in every case. The whole specimens were cut serially and the sections were stained.Results and conclusionIn this paper, an attempt to define a criteria or a classification of esophagitis has been done in order to apply to clinical observations. (1) The grade of esophagitis was classified in four grades macroscopically according to the autopsy findings of dogs.Reddening and edema of the esophageal fold were defined as the grade I. The grade II was longitudinal linear erosion or ulceration and the grade III was conjugated erosion or ulceration. Deep ulceration and scar formation with or without esophageal stenosis were the grade IV.(2) The transitional change of esophagitis was discussed.(3) Many different features of esophagitis were understood as one process of inflammatory changes of the esophagus and not qualitative change but quantitative process.(4) A criteria for diagnosis of esophagitis was obtained radiologically, endoscopically and pathologically.

著者

• 熊谷 義也

  慶応義塾大学医学部外科学教室

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• An experimental study of reflux esophagitis due to acid

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