Diagnostic value of endoscopic markers for celiac disease in adults: a multicentre prospective Italian study.

Aim: Some endoscopic features of duodenal mucosa are marker of mucosal injury, the most common cause being celiac disease (CD). The aim of this study was to prospectively assess the diagnostic value of the endoscopic markers for the diagnosis of CD in the adult population undergoing routine upper endoscopy.

Methods: This was a prospective multicenter study conducted at 37 Italian endoscopic centers.

Nodular hyperplasia of Brunner's glands.

A clinical, endoscopic, and histological study of 206 cases of nodular hyperplasia of Brunner's glands was carried out. Firm nodules with a reddened surface due to hyperplastic Brunner's glands were limited mainly to the first part of the duodenum and affected almost exclusively male patients. Gastric acid secretion after pentagastrin stimulation was significantly increased compared to normal.

Polypoid lesions associated with diverticular disease of the sigmoid colon.

Colonscopy performed in five patients because of narrowing of the sigmoid colon with intramural diverticula revealed several bright red, slightly elevated patches. In three patients, some bright red polypoid structures 1 cm in size and hemispherical in shape were also present. On light microscopy the polyps showed the features of transitional mucosa but revealed a different pattern of mucus secretion.

Gastritis cystica polyposa: a possible precancerous lesion.

Twenty polypoid lesions at gastroenterostomy stomas (the so-called gastritis cystica polyposa-GCP) were endoscopically removed from gastroenterostomy stomas of 16 male and two female patients previously operated for benign lesions. The interval from surgery ranged from 3 to 40 years (mean: 16.2 years).

Prevalence of gastroduodenal lesions in uremic patients undergoing dialysis and after renal transplantation.

Upper gastrointestinal endoscopic examination showed lesions in 28 of 112 dialysis uremic patients and in 19 of 52 after renal transplantation. Most patients with and without lesions were symptom free. A significant increase in gastric acid secretion was found in patients with transplant as compared with dialysis uremic patients.