Endoscopy 2019; 51(04): S150
DOI: 10.1055/s-0039-1681613
ESGE Days 2019 ePoster podium presentations
Friday, April 5, 2019 13:30 – 14:00: Stomach diagnosis 2 ePoster Podium 8
Georg Thieme Verlag KG Stuttgart · New York

WE CAN JUDGE THE PRESENT OR PAST H.PYLORI INFECTION WITH ONLY ONE ENDOSCOPIC CARDIAC IMAGE (WHALE SHARK SIGN: WSS)

T Yamasaki
1   Department of Internal Medicine, Division of Gastroentelogy and Hepatology, The Jikei University, School of Medicine, Tokyo, Japan
,
M Chibai
2   Surgery, Heiwadai Clinic, Tokyo, Japan
,
T Sakurai
1   Department of Internal Medicine, Division of Gastroentelogy and Hepatology, The Jikei University, School of Medicine, Tokyo, Japan
,
J Mitobe
1   Department of Internal Medicine, Division of Gastroentelogy and Hepatology, The Jikei University, School of Medicine, Tokyo, Japan
,
Y Maruyama
1   Department of Internal Medicine, Division of Gastroentelogy and Hepatology, The Jikei University, School of Medicine, Tokyo, Japan
,
H Miyashita
1   Department of Internal Medicine, Division of Gastroentelogy and Hepatology, The Jikei University, School of Medicine, Tokyo, Japan
,
Y Akita
1   Department of Internal Medicine, Division of Gastroentelogy and Hepatology, The Jikei University, School of Medicine, Tokyo, Japan
,
R Miyazaki
1   Department of Internal Medicine, Division of Gastroentelogy and Hepatology, The Jikei University, School of Medicine, Tokyo, Japan
,
M Mitsunaga
1   Department of Internal Medicine, Division of Gastroentelogy and Hepatology, The Jikei University, School of Medicine, Tokyo, Japan
,
M Saruta
1   Department of Internal Medicine, Division of Gastroentelogy and Hepatology, The Jikei University, School of Medicine, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 
 

    Aims:

    We have confused with various newly endoscopic findings (patchy redness and map-like redness etc.) after H.pylori (HP) eradication. On this time, we have found out a new other ultimate useful finding showing HP related gastritis at gastric cardia including present and post HP infection. Our aim of this study is to elucidate the possibility of judgement with only this cardiac endoscopic view about presence or absence with HP infection.

    Methods:

    We have found out so useful and specific cardiac image (Whale Shark Sign: WSS) closely related to HP infection five years ago. We have examined the presence of WSS on 5, 132 cases that have been able to overview on their endoscopic profiles. The 4,833 cases their serum HP antibody titers were measured from Jan. 2012 to Oct. 2018. A total of 3,579 patients (HP positive) were enrolled.

    Results:

    Mean age of patients was 53.2 years old. The positive predictive value (PPV) of WSS was surprisingly high (98.7%). According to this high PPV, we can think WSS positive cases are high risk of gastric cancer. This WSS mean that the presence of irregular gastric mucosal surface pattern and the presence of lymphoid hyperplasia, that showing HP infectious stomach. This lymphoid hyperplasia at gastric cardia were recognized small round whitish nodules on white light endoscopy. And this was more emphasized with image-enhanced endoscopy (Narrow Band Imaging: NBI), it looks like Whale Shark. This WSS sign is so simple and easy for every gastroenterologist. It is so useful to know gastric cancer risk at gastric entrance (cardia) with the presence of an easy simple sign.

    Conclusions:

    We have been able to judge the presence of HP infection with only cardiac endoscopic image (WSS). Since this sign is very easy and simple, everyone will be able to judge the presence of HP infection and gastric cancer risk.


    #