Comparison of Snare and Large Forceps Biopsies in the Histologic Diagnosis of Gastric Vascular Ectasia in Cirrhosis

Abstract

To compare snare and large forceps biopsies in the histologic diagnosis of gastric vascular ectasia (GVE) in cirrhosis, two groups of patients were studied: (a) 8 cirrhotic patients in whom endoscopy disclosed multiple gastric red spots (GRS), and (b) 5 cirrhotic patients with no GRS. Histologic examination of snare specimens identified dilated capillaries in the mucosa of the stomach in 75% of the cirrhotic patients with GRS, while large forceps specimens enabled the diagnosis of GVE only in 20% of the cases (p less than 0.05). Morphometric analysis of snare specimens demonstrated a significantly greater mean mucosal capillary cross-sectional area in cirrhotic patients with GRS than in cirrhotic patients without these lesions (p less than 0.05), while no differences in this parameter was observed in large forceps specimens. These findings indicate that gastric mucosal specimens obtained with large forceps are not useful for establishing the histologic diagnosis of GVE in cirrhotic patients with GRS.

Impaired Accommodation of Proximal Stomach in Patients with Alcoholic Liver Cirrhosis

“…In liver cirrhosis, the levels of each of the ve gastrointestinal hormones affecting the gastric motility, i.e. secretin (44,45) glucagon (46), gastrin (44,47), motilin (44,48) and CCK (49,50), were found to be either normal or elevated in cirrhotic patients. The effect of fat on the proximal stomach is thought to be mediated by both CCKdependent and CCK-independent mechanisms (51)(52)(53).…”

Thickened gastric mucosal capillary wall: A histological marker for portal hypertension

“…However, to be of any practical importance the changes in mucosal capillaries have to be defined in biopsy material obtained by endoscopic pinch biopsy because of the safety and ease with which they can be obtained. Saperas et al 19 concluded that specimens obtained with large biopsy forceps were not useful for histological diagnosis of vascular ectasia in cirrhotics. However, they did not comment on the thickness of the capillary wall.…”

Comparative Study of Portal Hypertensive Gastropathy in Schistosomiasis and Hepatic Cirrhosis

“…Gastric tissue samples of at least 1 cm in diameter (macrobiopsies) were obtained from the greater curvature of the body, using a polypectomy snare and cutting with electrical current, as proposed by Saperas et al [9]. The specimens were fixed in formaldehyde and stained using the hematoxylin-eosin and Verhoff methods.…”