Implications of Gastric Diverticulum in the Incidence of Metaplasia: An Analysis of 37 Cases

Year 2023, Volume: 5 Issue: 3, 632 - 7, 18.09.2023

Ali Muhtaroğlu , Ersin Kuloğlu , Kubilay İşsever , Ahmet Dülger

https://doi.org/10.37990/medr.1328204

Abstract

Aim: The present study aimed to investigate the potential association between gastric fundus diverticulum and metaplasia by retrospectively analysing patient data and biopsy results.
Material and Methods: 37 patients with gastric fundus diverticulum were examined, with their data compared to a control group of 50 patients without it. All diagnoses were made endoscopically. Demographic information, laboratory parameters, and endoscopic biopsy results were compared between the groups.
Results: No significant differences were identified between the two groups concerning several laboratory parameters. However, there were significant differences in lymphocytes, urea, albumin, Na, and K values (p<0.05). Helicobacter pylori and atrophy distributions did not differ between the groups (p>0.05), while a notable difference was seen in the distribution of metaplasia (p<0.05). Metaplasia positivity was found to be 16% in patients without gastric diverticulum and 43.2% in patients with gastric diverticulum.
Conclusions: This study found a higher prevalence of metaplasia positivity in patients with gastric diverticulum than those without. These findings suggest a potentially significant link between the gastric diverticulum and the occurrence of metaplasia, which warrants further research to better understand the underlying mechanisms and implications for patient management.

Keywords

gastric diverticula, metaplasia, gastric biopsy, endoscopy, gastroenterology

Supporting Institution

YOK

Project Number

-

Thanks

We would like to express our gratitude to Aysun GÜLER, the head nurse of the endoscopy unit of our institution, and her team for their devoted work.

References

• 1. Shah J, Patel K, Sunkara T, et al. Gastric diverticulum: a comprehensive review. Inflamm Intest Dis. 2019;3:161-6.
• 2. Mohan P, Ananthavadivelu M, Venkataraman J. Gastric diverticulum. CMAJ. 2010;182:E226.
• 3. Al Ghadeer HA, Al Hassan AS, AlAli NH, et al. An incidental finding of asymptomatic gastric diverticula. Cureus. 2022;14:e31250.
• 4. Podda M, Atzeni J, Messina Campanella A, et al. Syncope with surprise: an unexpected finding of huge gastric diverticulum. Case Rep Surg. 2016;2016:1941293.
• 5. Ho MF, Teoh AY, Liu SY, et al. Perforated gastric diverticulum with bleeding. Endoscopy. 2013;45:E422-E423.
• 6. Silva G, Moreira Silva H, Tavares MD, Lima R. Multiple gastric diverticula. GE Port J Gastroenterol. 2019;26:454-5.
• 7. Akkari I, Mraiedha MH, Jemni I, et al. Gastric diverticula as a diagnostic and therapeutic challenge: case report and review of literature. Int J Surg Case Rep. 2020;70:93-5.
• 8. Pietrzak C, Leya J, Abood G, et al. Recurrent intra-abdominal abscess formation due to a gastric diverticulum. Endoscopy. 2013;45:E345-E346.
• 9. Simon M, Zuber-Jerger I, Schölmerich J. True gastric diverticulum. Dig Liver Dis. 2009;41:370.
• 10. Velanovich V. Gastric diverticulum. Endoscopic and radiologic appearance. Surg Endosc. 1994;8:1338-9.
• 11. Hajini FF, Husain M, Bhat A, Bukhari SI. Gastric diverticulum a rare endoscopic finding. BMJ Case Rep. 2014;2014:bcr2013202887.
• 12. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process--First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res. 1992;52:6735-40.
• 13. Ölmez S, Aslan M, Yavuz A, Sarıtaş B. Coexistence of gastric diverticulum and gastric cancer. Gastroenterol Nurs. 2018;41:166-8.
• 14. Fork FT, Tóth E, Lindström C. Early gastric cancer in a fundic diverticulum. Endoscopy. 1998;30:S2.
• 15. Marianne C, Ur Rehman M, Min Hoe C. A case report of large gastric diverticulum with literature review. Int J Surg Case Rep. 2018;44:82-4.
• 16. Camilleri M, Sandler RS, Peery AF. Etiopathogenetic mechanisms in diverticular disease of the colon. Cell Mol Gastroenterol Hepatol. 2020;9:15-32.
• 17. Strate LL, Morris AM. Epidemiology, pathophysiology, and treatment of diverticulitis. Gastroenterology. 2019;156:1282-1298.e1.