Clinical features of acute esophageal mucosal lesions and reflux esophagitis Los Angeles classification grade D: A retrospective study  

作　　者：Chikamasa Ichita Akiko Sasaki Sayuri Shimizu 

机构地区：[1]Department of Gastroenterology Medicine Center,Shonan Kamakura General Hospital,Kamakura 247-8533,Kanagawa,Japan [2]Department of Health Data Science,Yokohama City University,Yokohama 236–0027,Kanagawa,Japan

出　　处：《World Journal of Gastrointestinal Surgery》2023年第3期408-419,共12页世界胃肠外科杂志（英文版）（电子版）

摘　　要：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.

关 键 词：Acute esophageal mucosal lesion COMORBIDITIES Esophageal reflux Black esophagus Acute necrotizing esophagitis 

分 类 号：R571[医药卫生—消化系统]