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Abstract

Background: Studies with the latest technologies such as endoscopy with magnification and chromoendoscopy showed that various endoscopic aspects are clearly related to infection by Helicobacter pylori (HP). The description of different patterns of erythema in gastric body under magnification of images revived interest in identifying these patterns by standard endoscopy. Aim: Validate endoscopic aspects related to HP found in conventional videogastroscopy, allowing the predictability of the diagnosis as well as proper targeting biopsies. Methods: Prospective study of 339 consecutive patients with the standard videoendoscope image analysis were obtained, recorded and stored in a program database. These images were studied with respect to the presence or absence of HP, diagnosed by rapid urease test and/or by histological analysis. We studied: normal mucosa appearance; mucosal nodularity; diffuse nonspecific erythema or redness of antrum and body; mosaic pattern with focal area of hyperemia; erythema in streaks or bands (red streaks); elevated (raised) erosions; flat erosions and fundic gland polyps. The main exclusion criteria were the use of drugs, HP pre-treatment and other entities that could affect results. Results: Applying the exclusion criteria, were included 170 of the 339 patients, of which 52 (30.58%) were positive for HP and 118 negative. On the positive findings, the most associated with infection were: antral nodularity (26.92%); raised erosion (15.38%) and mosaic pattern in the body (21,15%). On the negative group the normal appearance of the mucosa was 66.94%; red streaks in 9.32%; flat erosions 11.86%; and fundic gland polyps 11.86%. Conclusion: Endoscopic findings are useful in predicting the outcome, localization and targeting of biopsies in gastritis related to HP infection. The most representative form of HP related gastritis was the nodularity of the antral mucosa. The raised erosion and mosaic pattern in the body are suggestive but not specific to the infection. Normal-appearing forms, red streaks and fundic gland polyposis are related to the negativity of HP infection. The other forms were not conclusive of the presence of HP.

Biography

Alexandre Gomes has graduated in 1985 at the Faculty of Medicine of Sorocaba, São Paulo, has completed his Medical Residency in Digestive Surgery at HSPE São Paulo, specialist titles in General Surgery (CBC), Digestive Surgery (CBCD), Clinical Gastroenterology (FBG) and Endoscopy (SOBED). He has completed his Master's degree in Principles of Surgery from University Evangelic Hospital of Curitiba, Brazil. He was an Ex-Assistant Professor of General Surgery at the Tatuapé Hospital of São Paulo and the Regional Hospital of Sorocaba. In the last ten years, he is working exclusively with endoscopic procedures (endoscopy, colonoscopy, ERCP, endoscopic ultrasound EUS)