Morphoclinic correlations in gastroesophageal reflux disease

Abstract

Introduction. The esophageal junction (the epifrenic, intrahiatal and abdominal portions of the esophagus and the cardia) was highlighted by the medical community as a remarkable segment of the digestive tract and as a distinct anatomical-clinical entity. Lately, several pathologies have been completed with a morphopathological substrate as this anatomical area, including gastroesophageal reflux disease, hiatal hernia, Barrett's esophagus. Gastroesophageal reflux disease is the most common pathology of the digestive tract, being considered "21st Century Disease". Aim of the study. Evaluation of morphoclinic peculiarities of the esophagogastric junction in patients with gastroesophageal reflux disease. Materials and methods. The study lot consisted of 273 patients diagnosed with gastroesophageal reflux disease, which represents 9.12% of a total of 2997 patients admitted to the gastroenterology department of IMSP SCR "Timofei Moşneaga" during 2009-2012. Modern methods of investigation always highlight the morphopathological substrate in this pathology. Results. The endoscopic examination revealed the presence of erosive esophagitis in 18.32% of cases and the Barrett esophagus - 5.78%; the incompetence of the inferior esophageal sphincter of 1st grade was determined in 28.35% cases, the second degree - 33.87% and the third degree - 37.78%. Radiological examination identified hiatal hernia in 7.75% of cases and gastroesophageal reflux: high (cardia-to C VI) in 29.45% cases; medium (up to T VI) - 47.28% and down (up to T XI-XII) - 23.25%. Conclusios. Incompetence of the lower esophageal sphincter and gastroesophageal reflux forms explains the extent of lesions on the esophageal mucosal surface while also arguing for atypical symptoms (cervical, respiratory and cardiac) in gastroesophageal reflux disease. Based on the results of the study, we can conclude that gastroesophageal reflux disease is manifested when incompetence of antireflux mechanisms arises.