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Endoscopic measurement of cardia circumference as an indicator of GERD

Ann K Seltman1, Peter J Kahrilas, Eugene Y Chang

  • 1Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA.

Gastrointestinal Endoscopy
|December 27, 2005
PubMed

Insights

Larger cardia circumference correlates with gastroesophageal reflux disease (GERD) and its severity. This finding suggests cardia circumference measurement may aid in GERD diagnosis.

Area of Science:

  • Gastroenterology
  • Medical Imaging Analysis

Background:

  • Repeated gastric distention is theorized to cause cardia dilatation and gastroesophageal reflux disease (GERD).
  • Cardia circumference is hypothesized to correlate with GERD presence and severity.

Purpose of the Study:

  • Validate software for measuring cardia circumference from endoscopic images.
  • Quantify cardia circumference across the GERD spectrum.

Main Methods:

  • Software measurements were validated against actual measurements in animal and mechanical models.
  • A retrospective review included 273 subjects (controls, GERD, Barrett's esophagus).
  • A blinded abstractor measured cardia circumference using endoscopic images.

Main Results:

  • Software and actual measurements showed high correlation and reproducibility.
  • Median cardia circumference: control (31.8 mm), GERD (37.8 mm), <3cm Barrett's (38.4 mm), >3cm Barrett's (45.0 mm) (p < 0.001).
  • A 34.3 mm cutoff yielded 85.3% sensitivity and 89.6% specificity for GERD diagnosis.

Conclusions:

  • A direct relationship exists between cardia circumference and GERD.
  • Cardia circumference measurement may serve as a valuable diagnostic tool for GERD.
  • Findings enhance understanding of esophagogastric junction's role in GERD pathogenesis.
Abstract

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