Endoscopic diagnostic criteria (Fig. 3.42)

► Bile-tinged esophageal secretion

► Previously operated stomach

► Mucosal damage like that seen in peptic reflux esophagitis

Differential diagnosis

► Peptic esophagitis

Checklist for endoscopic evaluation

► Look for bile-tinged secretion

► Evaluate gastroesophageal junction

► Describe mucosal findings

► Determine extent of mucosal findings

► Identify postoperative anatomy

► Outflow obstruction?

Additional Studies

► Gastric juice sample for pH measurement

► Upper gastrointestinal contrast series: Reflux? Obstruction?


A trial of antacids or sucralfate is recommended. A prokinetic agent should also be administered.

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