M. Guelrud et I. Herrera, ACETIC-ACID IMPROVES IDENTIFICATION OF REMNANT ISLANDS OF BARRETTS EPITHELIUM AFTER ENDOSCOPIC THERAPY, Gastrointestinal endoscopy, 47(6), 1998, pp. 512-515
Background: Instillation of acetic acid onto the uterine cervix at col
poscopy has been used fear many years to highlight dysplastic areas an
d thereby enhance the ability to obtain targeted biopsy specimens. As
part of an ongoing trial of multipolar electrocoagulation for Barrett'
s esophagus, we sought to develop a simple technique to identify small
islands of residual specialized columnar epithelium after treatment.
Methods: In 21 consecutive patients, 5 to 10 mt of 1.5% acetic acid wa
s sprayed onto the distal esophagus using a spray catheter, followed i
mmediately by spraying 50 mt of tap water. Results: Initially, a whiti
sh coloration developed in both esophageal and gastric epithelia. Afte
r 2 to 3 minutes, the esophageal squamous mucosa remained white but th
e columnar epithelium became reddish. Remnant islands of Barrett's epi
thelium were outlined by a white rim. Conclusion: Acetic acid instilla
tion enhances the ability to detect small or indistinguishable remnant
islands of columnar epithelium after endoscopic treatment of Barrett'
s esophagus. This method is safe, rapid, and inexpensive.