el-Zayadi A, Montasser M F, Girgis F, el-Okby S, Botros B, Mohran Z
Dept. of Tropical Medicine, Ain Shams University, Cairo, Egypt.
Endoscopy. 1989 Sep;21(5):205-7. doi: 10.1055/s-2007-1012948.
There is considerable controversy as regards the exact cause of bleeding from esophageal varices. This study examined changes in the mucosa of such patients in an effort to understand the underlying mechanisms. Fifty patients were studied, 20 with a history of variceal bleeding and 30 without who served as controls. Endoscopic biopsies were taken from the inter-variceal mucosa within 5 cm from the cardia and were examined histopathologically. The results showed dilated intra-epithelial blood-filled channels within the squamous epithelium and the lamina propria in all bleeders, and in 50% of the non-bleeders. Evidence of esophagitis was also more pronounced in bleeders (50%) than in non-bleeders (23.3%). It is our opinion that esophagitis and the presence of dilated blood-filled channels may play a role in the initiation of variceal bleeding.
关于食管静脉曲张出血的确切原因存在相当大的争议。本研究检查了此类患者黏膜的变化，以了解其潜在机制。研究了50名患者，其中20名有静脉曲张出血史，30名无出血史作为对照。在内镜下从距贲门5厘米内的曲张静脉间黏膜取活检组织，并进行组织病理学检查。结果显示，所有出血患者以及50%的非出血患者的鳞状上皮和固有层内有扩张的上皮内充血通道。食管炎的证据在出血患者（50%）中也比非出血患者（23.3%）中更明显。我们认为食管炎和扩张的充血通道可能在静脉曲张出血的起始中起作用。
