Abstract
We have reviewed articles on the longitudinal vessels observed in the lower esophagus. In our previous study, we observed longitudinal (palisading) vessels through the mucosal epithelium in 884 (98%) of 905 consecutive endoscopic examinations of the lower esophagus, whereas in 20 examinations (2%) they could not be observed because of inflammation. The lengths of the longitudinal vessels were within the range of 2 to 3 cm in 90% of investigations. “Indentation” (notch or narrowing) compatible with the esophageal hiatus was observed in the transitional zone between the tubal esophagus and saccular stomach by both radiographic (as an indentation) and endoscopic (as a narrowing; we used the term indentation in this article) examinations. In cases without hiatal hernia, the indentation coincided with the esophagogastric junction (EGJ). We examined endoscopically the relationships among the locations of the indentation, squamocolumnar junction, and the longitudinal vessels. In no patients did we observe longitudinal vessels through the gastric mucosa beyond the indentation. Therefore, observation of longitudinal vessels through the mucosal epithelium was an indicator that the mucosa was located within the esophagus. However, in 21% of the 884 observations, columnar-lined mucosa was seen continuously from the gastric mucosa proximally beyond the indentation, and longitudinal vessels were observed through this columnar-lined mucosa. Because the longitudinal vessels were peculiar to the esophageal mucosa, we could assume that this columnar-lined mucosa was located within the esophagus and was Barrett's mucosa, although very short. Therefore, Barrett's mucosa can be precisely diagnosed endoscopically by using the longitudinal vessels as diagnostic markers. The Japan Esophageal Society has authorized the endoscopic definition that the lower ends of the longitudinal vessels mark the limit of the EGJ.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
