Murphy P P, Ballinger P J, Massey B T, Shaker R, Hogan W J
Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, USA.
Endoscopy. 1998 May;30(4):367-70. doi: 10.1055/s-2007-1001284.
Although discrete ulcers are a recognized complication of Barrett's esophagus, it is not clear how common discrete ulceration is in Barrett's mucosa. Furthermore, the relationship of gastrointestinal hemorrhage to Barrett's ulceration is unknown. These issues were investigated in this paper.
Seventy-eight patients with histologically confirmed Barrett's esophagus were monitored by endoscopic surveillance over 1 to 11 years (mean 3.3 years). The incidence of a Barrett's ulcer was noted and its site recorded. The frequency of gastrointestinal hemorrhage at diagnosis or on follow-up was documented and the source of the bleeding was identified.
Discrete ulcers were identified in 36 of 78 patients (46%) at some time over the period of follow-up. Eight patients had two or more ulcers. Most of ulcers were in the distal esophagus; 86% of these were within 3 cm of the anatomic gastroesophageal junction. Nineteen patients (24%) either presented with active gastrointestinal bleeding or had bleeding at follow-up. In 15 of the 19 patients with bleeding (79%) a discrete Barrett's ulcer was the source of the hemorrhage.
Ulceration is a common complication of Barrett's esophagus. These ulcers are usually located close the gastroesophageal junction and have a high incidence of bleeding.
尽管散在溃疡是巴雷特食管公认的并发症，但散在溃疡在巴雷特黏膜中的常见程度尚不清楚。此外，胃肠道出血与巴雷特溃疡的关系也不明确。本文对这些问题进行了研究。
对78例经组织学确诊的巴雷特食管患者进行了1至11年（平均3.3年）的内镜监测。记录巴雷特溃疡的发生率及其部位。记录诊断时或随访期间胃肠道出血的频率，并确定出血来源。
在随访期间，78例患者中有36例（46%）在某个时间点发现了散在溃疡。8例患者有两个或更多溃疡。大多数溃疡位于食管远端；其中86%位于解剖学胃食管交界处3厘米范围内。19例患者（24%）在就诊时出现活动性胃肠道出血或在随访期间出血。在19例出血患者中的15例（79%），散在的巴雷特溃疡是出血来源。
溃疡是巴雷特食管的常见并发症。这些溃疡通常位于胃食管交界处附近，出血发生率高。
