MICROVASCULAR LESIONS IN REFLUX ESOPHAGITIS AND BARRETTS-ESOPHAGUS

In 30 patients with reflux oesophagitis, the mucosal microvessels have been studied by transmission electron microscopy. The aim of the stud y was to test the hypothesis that a microvascular injury is involved i n reflux oesophagitis, and to clarify if the epithelial metaplasia is correlated with a contemporaneous modification of the microvasculature in Barrett's oesophagus. In squamous epithelium-lined mucosa, signs o f microangiopathy were found in all patients and capillaries regularly showed an interrupted, duplicated, or thickened basal lamina. In area s of columnar metaplasia, capillaries showed an ectatic lumen and a th in basal lamina without duplications or interruptions; endothelial cel ls had a thin rim of cytoplasm with many fenestrations. These findings demonstrate that microangiopathy is associated with epithelial damage in reflux oesophagitis.