Grade IIV Reflux Esophagitis
The inflammatory lesions of reflux esophagitis are currently graded according to the Savary-Miller classification, which is summarized in Table 3.4.
Grades I-III. Grades I-III (Fig. 3.25) reflect a more or less pronounced acute attack. These grades may be complicated by superficial bleeding, but some cases initially resolve without sequelae.
Grade IV. Grade IV (Fig. 3.26) represents the chronic, complicated stage of reflux esophagitis, which is subject to its own dynamic. The most serious complications are obstructive strictures and adenocarcinoma secondary to columnar metaplasia of the esophageal epithelium.
|
Grade |
Endoscopic findings |
|
I |
One or more nonconfluent, longitudinal mucosal lesions with erythema and exudate |
|
II |
Confluent erosive and exudative lesions not covering the entire circumference of the esophagus |
|
III |
Erosive and exudative lesions covering the entire circumference of the esophagus |
|
IV |
Chronic mucosal lesions such as ulcer, stricture, and Barrett esophagus |
- Fig. 3.25 Grading of reflux esophagitis
- Fig. 3.25 Grading of reflux esophagitis
a Grade I: streaky lesions b Grade II: streaky, confluent lesions c Grade III: circumferential lesions a Grade I: streaky lesions b Grade II: streaky, confluent lesions c Grade III: circumferential lesions
Fig. 3.26 Grade IV reflux esophagitis a Ulcer b Barrett epithelium c Peptic stricture
Fig. 3.26 Grade IV reflux esophagitis a Ulcer b Barrett epithelium c Peptic stricture
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