PubMed · 4565096
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T Takemoto, K Yamada, S Suzuki, M Endo. 1972. [Cardia function--gastroscopic studies].. https://pubmed.ncbi.nlm.nih.gov/4565096/
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The gastric cardia is a microscopic zone that is normally found in the most proximal portion of the stomach, although cardiac-type mucosa may arise in the distal esophagus as a metaplastic phenomenon secondary to gastroesophageal reflux disease (GERD). Inflammation of the native gastric cardia is strongly associated with Helicobacter pylori infection, although there may be a second form of 'carditis' in which metaplastic cardiac-type mucosa becomes inflamed secondary to GERD. Intestinal metaplasia of the cardia may be difficult to recognize because of the difficulty in accurately identifying the esophagogastric junction by endoscopy and the histologic similarities of intestinal metaplasia in the proximal stomach and distal esophagus. However, cytokeratin 7 and 20 immunoreactivity patterns appear to be useful in distinguishing between these forms of intestinal metaplasia. The preponderance of data suggests that intestinal metaplasia of the cardia is associated with H. pylori infection as opposed to GERD, and preliminary data suggest a lower risk of progression to dysplasia and adenocarcinoma when compared to intestinal metaplasia of the distal esophagus.
The results of treatment of the patients with bleeding ulcers of cardial part of the stomach have been analysed. In contrast to gastric ulcers of another location, cardial ones are poorly respond conservative treatment, are usually accompanied by severe complications, and are more frequently prone to malignant transformation. New method for proximal resection of the stomach has been developed, which was successfully used in 14 patients. There were no complications and lethal outcomes. Yearly and long-term results were favourable.
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