196446

ENDOSCOPIC VERSUS HISTOPATHOLOGICAL DIAGNOSIS OF PAN-GASTRITIS IN PATIENTS WITH CHRONIC GASTRIC DYSPEPSIA

Article

Last updated: 04 Jan 2025

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Tags

Medicine

Abstract

Background: Dyspepsia is a clinical syndrome including manifestations related to the upper gastrointestinal tract. Options for evaluating dyspeptic patients include therapeutic trials, testing for Helicobacter pylori, upper gastrointestinal (UGI) radiography, and endoscopy. Objective: To compare the endoscopic and histopathologic diagnosis of gastritis in patients presented with chronic gastric dyspepsia to evaluate the relative frequency and pattern of different types of gastritis in patients presented with chronic gastric dyspepsia. Patient and method: Prospective cross-sectional study on 120 patients with chronic dyspepsia more than 8 weeks. All patients underwent gastroscopy. The findings of gastric inspection were recorded for all patients. Biopsy specimens were taken. Two from the anterior and posterior antrum, two from the anterior and posterior body, and two from any additional area of abnormality. Diagnostic criteria were applied to histological features and each histopathological parameter (chronic inflammation, activity, atrophy, intestinal metaplasia and H. pylori density) were graded for assessment of their severity as 0= absent, 1= mild, 2=moderate or 3= severe in the corpus and antrum. Results: Endoscope revealed normal gastric mucosa in 33 patients (27.5%), gastritis in 64 patients (53.3%) and other lesions in 23 patients (19.2%). As regard gastritis, there was edema in 61 patients (95.3%), erythema in 45 patients (70.3%), atrophy in 10 patients (15.6%) and mucosal nodularity in 10 patients (15.6%). As regard location of gastritis, it was pan-gastritis in 44 patients (68.8%), Antrum predominant gastritis in 10 patients (15.6%) & corpus predominant gastritis in 10 patients (15.6%).As regard other lesions, there was Duodenal ulcer in 7 patients (30.4%), peptic ulcer in 3 patients (13%), esophagitis in 2 patients (8.7%), erosive gastritis in 4 patients (17.4%), upper GIT suspecting malignancy in 2 patients (8.7%) and hiatal hernia in 5 patients (21.7%). Histopathology results were Normal in 18 (18.6%), Chronic inflammation in 79 (81.4%), Neutrophilic infiltration in 60 (61.7%), Glandular atrophy in 10 (10.3%), Intestinal metaplasia in 3 (3.1%) and H. pylori density in 47 (48.5%). Gastritis was detected by Endoscopy in 64 (53.3%) and in 79 (81.4%) by histopathology. This difference was statistically significant (p-value: 0.014). Conclusion: The prevalence of gastritis among the dyspeptic patients is very high since we observed endoscopically gastritis in 64 patients (53.3%) and other lesions in 23 patients (19.2%). The concordance between endoscopic findings and histopathological diagnosis of gastritis was (81%). High prevalence of H.Pylori among the dyspeptic patients (48.5%). Gastritis was better detected by histopathology.

DOI

10.21608/amj.2021.196446

Keywords

Endoscopy, histopathology, Pan-gastritis, Dyspepsia

Authors

First Name

Mahmoud

Last Name

Kamel Abdo Metawae

MiddleName

-

Affiliation

Departments of Hepto- Gastroenterology & Infectious diseases, Faculty of Medicine, Al-Azhar University

Email

mahmoudmetawe8@gmail.com

City

-

Orcid

-

First Name

Nasser

Last Name

Kamal El-Hamshary

MiddleName

-

Affiliation

Departments of Hepto- Gastroenterology & Infectious diseases, Faculty of Medicine, Al-Azhar University

Email

-

City

-

Orcid

-

First Name

Diaa

Last Name

Mohammad El-Teby

MiddleName

-

Affiliation

Departments of Hepto- Gastroenterology & Infectious diseases, Faculty of Medicine, Al-Azhar University

Email

-

City

-

Orcid

-

First Name

Sayed

Last Name

Abd El-Raheem Sayed Ali

MiddleName

-

Affiliation

Departments of Pathology, Faculty of Medicine, Al-Azhar University

Email

-

City

-

Orcid

-

Volume

50

Article Issue

4

Related Issue

27826

Issue Date

2021-10-01

Receive Date

2021-09-27

Publish Date

2021-10-01

Page Start

3,039

Page End

3,050

Print ISSN

1110-0400

Link

https://amj.journals.ekb.eg/article_196446.html

Detail API

https://amj.journals.ekb.eg/service?article_code=196446

Order

58

Type

Original Article

Type Code

941

Publication Type

Journal

Publication Title

Al-Azhar Medical Journal

Publication Link

https://amj.journals.ekb.eg/

MainTitle

ENDOSCOPIC VERSUS HISTOPATHOLOGICAL DIAGNOSIS OF PAN-GASTRITIS IN PATIENTS WITH CHRONIC GASTRIC DYSPEPSIA

Details

Type

Article

Created At

22 Jan 2023