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Histological Features of the Gastric Mucosa in Children With Primary Bile Reflux Gastritis

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Histological Features of the Gastric Mucosa in Children With Primary Bile Reflux Gastritis

Yanyi Zhang et al. World J Surg Oncol.

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.

Figures

Figure 1
Figure 1
Lymphatic follicle in the gastric mucosa in patients with bile reflux (HE staining, magnification 100×).
Figure 2
Figure 2
Intestinal metaplasia in the gastric mucosa in patients with bile reflux (HE staining, magnification 100×).
Figure 3
Figure 3
Foveolar hyperplasia in the gastric mucosa in patients with bile reflux (HE staining, magnification 100×).
Figure 4
Figure 4
Interstitial edema in the gastric mucosa in patients with bile reflux (HE staining, magnification 100×).
Figure 5
Figure 5
Vascular congestion in the gastric mucosa in patients with bile reflux (HE staining, magnification 100×).
Figure 6
Figure 6
Fibroproliferation in the gastric mucosa in patients with bile reflux (HE staining, magnification 100×).

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References

    1. Genta RM. Differential diagnosis of reactive gastropathy. Semin Diag Pathol. 2005;22:273–283. doi: 10.1053/j.semdp.2006.04.001. - DOI - PubMed
    1. Johannesson KA, Hammar E, Stael von Holstein C. Mucosal changes in the gastric remnant: long-term effects of bile reflux diversion and helicobacter pylori infection. Eur J Gastroenterol Hepatol. 2003;15:35–40. doi: 10.1097/00042737-200301000-00007. - DOI - PubMed
    1. Mason RJ, De Meester TR. Importance of duodenogastric reflux in the surgical outpatient practice. Hepato Gastroenterol. 1999;46:48–53. - PubMed
    1. Dixon MF, O'Connor HJ, Axon AT, King RF, Johnston D. Reflux gastritis: Distinct histopathologic entity. J Clin Pathol. 1986;39:524–530. doi: 10.1136/jcp.39.5.524. - DOI - PMC - PubMed
    1. Sobola GM, O'Connor HJ, Dewar EP, King RF, Axon AT, Dixon MF. Bile reflux and intestinal metaplasia in gastric mucosa. J Clin Pathol. 1993;46:235–240. doi: 10.1136/jcp.46.3.235. - DOI - PMC - PubMed

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