Barret esophagus. Etiopathogenesis. Diagnostic and therapeutic aspects

Abstract

Introduction: Barrett's esophagus is a attractive pathology in gastroenterology for two fundamental reasons. Although its true prevalence is unknown, due largely asymptomatic cases, the widespread introduction of endoscopy allows us to assert that Barret esophagus is a relatively frequent. Esophagus surgery presents particular technical difficulties compared to other organs, because of its position, difficult -to reach and relation with a number of vital organs. Purpose and objectivities: studying the risk factors,the olldness of the pathology,studying subjective and objective clinical signs,endoscopic and radiological analyse. Materials and methods: This research is based on analys of 154 patiens with gastro-esophagian reflux disease and barrett esophagus,examined in Public Healthcare Institution,Republican Center of Medical Diagnosis,during 2014 year.The patients were divided into 2 groups:first with 140 (90%)patients with gastro-esophagian reflux disease and the second that included 14 (10%)patients with Barret esophagus.Results: The clinical examination included 154 patiants to which was revealed: GERD,esopgagitis and Barret esophagus.The male sex was predominant and represented 104(67.5%)patients and female sex represented 50(32.4%) patients. The clinical signs was determined by heartburn that was revealed at 130 patients(92%) from first group and 2 patients(14%) from second group.The second sign most commonly found was beltching that was revealed at 20 patients from first group(14%) and 9 cases from second group(64%).The endoscopic examination was the basic examination of all patients.At 103 patients from all(70%) was found evident signs of incapacity of inferior sphincter of esophagus,and namely the biant cardia,and its opening to a light air blast,but at 43 patients was not found these signs,despite of presence of clinical and endoscopic sign of esophagitis reflux.At 48 patients(32.9%),endoscopy set nonconfluent island hyperemia at lower region of the esophagus,which corresponded to the first level of reflux esophagities after Savary Miller.At 57patients(39%) was revealed hyperemia and confluent mucosal erosions that corresponded to the second level of reflux esophagities after Savary-Miller. The third level after Savary- Miller was found at 29 patients(19%) and the forth level at 12 patients (8%). The radiological examinations was performed at 106 patients from which 104 patients was with gastro-esophagian reflux disease,and 2 patients with Barret esophagus.At patiens with GERD-78 cases was found with radiological signs of reflux,but at 24 patients was not found any signs. Conclusions: Barret esophagus was found mostly at male sex,the averrage age being 45- 50years.The most common clinical signs was heartburn 89% cases,followed by epigastric pain and beltching-78%. At 103patients from all(70%) was found evident signs of incapacity of inferior sphincter of esophagus,and namely the biant cardia,and its opening to a light air blast,but at 43 patients was not found these signs,despite of presence of clinical and endoscopic sign of esophagitis reflux.