The clinical significance of thickened gastric folds found on upper gastrointestinal series.

GOALS: To assess the impact of upper endoscopy and biopsy on the outcome of patients with isolated thickened gastric folds found on barium upper gastrointestinal series (UGIS). STUDY: A total of 8,325 consecutive UGIS reports were reviewed to identify 182 patients who were found to have isolated thickened gastric folds. Patients with other serious radiographic abnormalities were excluded. The 182 patients were studied by a systematic review of the esophagogastroduodenoscopy (EGD) findings, gastric biopsy results, and clinical outcome. RESULTS: The study included 96 men (52.7%) and 86 women (47.3%) who had isolated thickened gastric folds on the UGIS. Seventy-four patients underwent EGD; 108 patients did not. The two groups were similar in demographic and clinical features. The EGD results were normal, 18 (24.3%); thick gastric folds, 12 (16.2%); hiatal hernia, 12 (16.2%); erythema/inflammation, 11 (14.9%); erosions, 8 (10.8%); portal gastropathy, 3 (4.1%); and gastric ulcer, 1 (1.4%). Forty-eight of the 74 EGD patients had a gastric biopsy. The findings were chronic active gastritis, 39 (81.3%); and chronic gastritis, 5 (10.4%). Evidence for H. pylori infection was present in 91.7% of the gastric biopsies. Outcome (mean follow-up, 28.5 months) was assessed in 49 patients in the EGD group and in 55 patients in the non-EGD group. There were no cases of serious or new UGI problems in either group. CONCLUSIONS: Isolated thickened gastric folds found on UGIS are frequently associated with H. pylori infection. Performing endoscopy and biopsy did not appear to alter the outcome in these patients.

Rectal duplication cyst in an adult: the laparoscopic approach.

BACKGROUND: Rectal duplication cyst (RDC) is a rare congenital anomaly representing 1% to 8% of all intestinal duplications. The case presented here is the first report of the laparoscopic resection of an RDC. METHODS: We report the case of a 49-year-old white woman in whom a retrorectal cystic mass measuring 5 x 5.3 x 6 cm was diagnosed. The mass was completely resected by means of laparoscopic techniques. RESULTS: Pathologic findings revealed a cystic structure partially lined with squamous as well as respiratory- and gastrointestinal-type epithelium. Muscularis propria was identified in the outer portions of the wall of the specimen. No atypia or malignancy was identified. The overall findings were consistent with an RDC. CONCLUSIONS: Laparoscopic resection constitutes an excellent and patient-friendly approach to the management of large adult cystic duplication of the rectum.