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Erosions of the stomach and 12-rectum - Diagnosis
Last reviewed: 04.07.2025
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Laboratory and instrumental data
1. During FEGDS, two main types of erosions are distinguished:
- flat (acute, hemorrhagic, incomplete) - superficial defects of the mucous membrane (point, linear, polygonal) usually up to 0.5 cm in diameter; they can be single or multiple, covered with fresh blood, hydrochloric hematin or fibrin. These changes are detected against the background of hyperemic and edematous mucous membrane; less often it turns out to be unchanged;
- chronic (complete, elevated) erosions - in the form of small protrusions of the mucous membrane with raised edges along the entire circumference and a depression in the center; they can be covered with a fibrinous coating and resemble skin changes in smallpox ("varioloform erosions").
FEGDS allows us to differentiate between mature and immature chronic complete erosions. Immature complete erosions are those that have only a rim of hyperemia at the top. Mature complete erosions are those with signs of desquamation and necrosis. Immature erosions are observed in the remission phase, mature ones - in the exacerbation phase.
Gastric erosions should be carefully differentiated from the erosive-ulcerative form of cancer, for which it is necessary to perform a biopsy from suspicious areas of the mucous membrane with subsequent morphological examination.
Research aimed at detecting Helicobacter pylori is also necessary .
- X-ray examination: when using the technique of double contrasting of the stomach in combination with dosed compression on the anterior abdominal wall, it is possible to identify erosions in the form of small rounded elevations with a diameter of 1-3 mm with a small accumulation of contrast agent in the center.
- Complete blood count: with hidden or obvious gastrointestinal bleeding, iron deficiency anemia develops with characteristic laboratory signs:
- decrease in the content of red blood cells and hemoglobin;
- hypochromia of erythrocytes;
- low color index;
- anisocytosis, poikilocytosis;
- decreased iron levels in the blood.
- Fecal occult blood test: in case of occult bleeding from erosions in the gastroduodenal region, the reaction to occult blood in the feces is positive.
- Examination of the secretory function of the stomach: most often, the secretory function of the stomach is normal or increased.
Survey program
- General analysis of blood, urine, feces.
- Fecal occult blood test.
- FEGDS with biopsy of the gastric mucosa.
- Diagnosis of Helicobacter pylori infection.
- Study of the secretory function of the stomach.
- Biochemical blood test: determination of iron, bilirubin, total protein and protein fractions, aminotransferases, urea, creatinine in the blood.
- X-ray examination of the stomach and duodenum
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