SHORT SEGMENT BARRETTS-ESOPHAGUS - CLINICAL AND HISTOLOGICAL FEATURES, ASSOCIATED ENDOSCOPIC FINDINGS, AND ASSOCIATION WITH GASTRIC INTESTINAL METAPLASIA

Objectives: To prospectively determine the clinical features, associat ed esophageal endoscopic lesions, associated gastric intestinal metapl asia, and prevalence of dysplasia and adenocarcinoma of short segment Barrett's. Methods: All patients undergoing upper endoscopy over a 5-m onth period were scrutinized for endoscopic features suggestive of sho rt segment Barrett's, and, if present, multiple biopsies were obtained from the suspicious areas. Prevalence of gastric intestinal metaplasi a was determined by obtaining biopsies from the antrum, body, and card ia. Results: Two hundred thirty seven patients were examined. Short se gment Barrett's was suspected in only 42 patients, and traditional Bar rett's was noted in 45 patients. Short segment Barrett's was confirmed by biopsy in 48%. Clinical presentation of short segment Barrett's wa s that of typical or complicated gastroesophageal reflux disease in 53 %. A hiatal hernia was the most common associated esophageal endoscopi c finding; however, none of the endoscopic findings differed significa ntly from findings of patients who did not have short segment Barrett' s. Diagnosis of short segment Barrett's required histological analysis . A significant difference was noted in the prevalence of intestinal m etaplasia between the esophagus and stomach in patients with Barrett's . No dysplasia or adenocarcinoma was detected in patients with short s egment Barrett's. Conclusions: Short segment Barrett's is a frequent f inding in patients undergoing upper endoscopy. All patients with short tongues or patches of red mucosa lying less than 2 cm above the esoph agogastric junction should be biopsied to exclude short segment Barret t's. Large scale endoscopic and histological surveillance studies alon g with long term follow-up are required to clarify short segment Barre tt's prevalence and cancer risk.