Gastroscopic experiences in the United States Army, Europe.

Abstract

1. Over a 3 year period, 1186 gastroscopies were performed in 925 patients in an Army General Hospital of the United States Army, Europe. Of the total, 650, or 70.3 per cent, revealed normal findings. This number is somewhat greater than those of other series, but is probably due to more routine use of gastroscopy in cases of obscure gastro-intestinal symptoms, plus the type of patient seen, time interval in referral, and conservatism in interpretation. Negative findings serve a definite purpose. 2. Two complications, one a case of pneumoperi-toneum and the other a perforation of the upper esophagus in an uncooperative patient, are reported. 3. Miscellaneous findings of interest included: 1) 3 diverticula, one of which was removed surgically; 2) 3 gastric tumors without ulceration, and 3) 1 case of adenomatous polyposis. 4. Gastric ulcers were relatively few (30 cases). Gastroscopy is believed superior to x-ray in the follow-up of these lesions, and in the diagnosis when the referral interval has been several weeks, as in many of our series. 5. Gastritis provided the majority of the gastroscopic findings, and the relative incidence in duodenal ulcer and with associated hemorrhage for which no other cause could be found, are shown. Hypertrophic gastritis was found to produce the most severe clinical symptoms, and 5 with moderate to severe polypoid formation, were observed, two of which underwent resection. Superficial gastritis was the most commonly noted form (47.5 per cent), but had fewest associated symptoms and the least chronic course, although it was the most frequent producer of hemorrhage (14 cases). Atrophic and mixed types were relatively infrequent.