Diagnosis

Differential diagnosis

► The typical appearance is unmistakable.

Checklist for endoscopic evaluation

► Typical appearance of the prolapse

► Signs of reflux disease

► Cardial incompetence

► Bleeding at the gastroesophageal junction

► Retroflexed view: bleeding in the cardial region

Endoscopic diagnostic criteria

Folds of stomach wall protrude into the distal esophagus during retching, appearing as a fungiform mass (Fig. 3.18)

Prolapsed stomach occupies all or part of the esophageal lumen

Detectable in the midesophagus and lower esophagus during endoscope insertion

Additional Studies

Comments

The clinical significance of gastroesophageal prolapse is uncertain. Complaints may occur during coughing and other acts that raise the intraabdominal pressure.

Fig. 3.17 Difference between gastroesophageal prolapse and sliding hernia

Fig. 3.17 Difference between gastroesophageal prolapse and sliding hernia

Gastroesophageal ProlapseGastroesophageal Prolapse
Fig. 3.18 a-d Gastroesophageal prolapse

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