ENDOSCOPIC DETECTION OF ISCHEMIA WITH A NEW PROBE INDICATES LOW OXYGENATION OF GASTRIC EPITHELIUM IN PORTAL HYPERTENSIVE GASTROPATHY

Changes in mucosal blood flow may be important in the pathogenesis of many conditions. Study of mucosal blood perfusion is difficult, and av ailable methods have significant technical limitations. This study des cribes the development of an instrument for endoscopy, which indicates blood flow indirectly, by measuring the quantity of tissue oxygen tha t can diffuse from the mucosa to a luminal surface electrode. The inst rument was used through an endoscope in patients with portal hypertens ion (n=14), scleroderma (n=3), disease controls (n=7), and normal cont rols (n=11). In portal hypertension readings were one quarter that in normal controls in both antrum (geometric mean (SEM) 35 (1.1)), nanoam ps v 137 (1.1), and upper corpus 34 (1.1) v 125 (1.1)). Scleroderma pa tients showed greatly reduced oxygen readings in both antrum (18 (1.2) ) and corpus (24 (1.2)), an expected but hitherto undiscovered result. These differences are highly significant (p=0.0001), and the findings suggest that tissue hypoxia may contribute to mucosal changes in port al hypertensive gastropathy and in scleroderma.