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Endoscopy 2011; 43(4): 365-368
DOI: 10.1055/s-0030-1256040
Case report/series

© Georg Thieme Verlag KG Stuttgart · New York

The significance of gastric and duodenal histological ischemia reported on endoscopic biopsy

J.  Herman1 , D.  Chavalitdhamrong1 , D.  M.  Jensen1 , 2 , 3 , G.  Cortina4 , A.  Manuyakorn4 , R.  Jutabha1, 2, 3
  • 1Center of Ulcer Research and Education (CURE), Digestive Diseases Research Center, Los Angeles, California, USA
  • 2Division of Digestive Diseases, David Geffen School of Medicine at University of California, Los Angeles, California, USA
  • 3VA Greater Los Angeles Healthcare Center, Los Angeles, California, USA
  • 4Department of Pathology, David Geffen School of Medicine at University of California, Los Angeles, California, USA
Further Information

Publication History

submitted 6 April 2010

accepted after revision 30 September 2010

Publication Date:
28 February 2011 (online)

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Although frequently reported, it is unknown whether pathological reports of ischemia obtained from gastroduodenal biopsies suggest a diagnosis, prognosis or a requirement for additional evaluation. The aim of this study was to review the natural history, clinical presentation, endoscopic appearance, treatments, and major clinical outcomes of patients with gastroduodenal ischemia. A case series of 14 patients with variable etiologies (seven gastric and seven duodenal) was obtained from a search of our endoscopic pathological database for reports of histological ischemia. The results were as follows. The most common presentation was upper gastrointestinal bleeding (71 %). Half of the endoscopic lesions appeared very severe (large or circumferential lesions, exudative, pseudomembranous, black or pale mucosa). There were six cases of rebleeding (43 %) and four deaths (29 %). Computed tomography scanning was frequently used (12 cases, 86 %), but led to an underlying diagnosis in only three cases. In our series, patients with underlying vascular pathology have substantial 6-month mortality (29 %).

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