Foveolar cell vacuolization in operated stomachs

Gastric biopsies from 223 patients were scrutinized for the presence of subnuclear vacuolization in the foveolar epithelium. The results demonstrated that foveolar epithelial vacuolization occurred in seven (15.9%) of 44 patients who had a previous Billroth I gastrectomy and in 56 (87.5%) of 64 patients who had a Billroth II remnant stomach. None of the 21 patients who had a vagotomy and pyloroplasty, and only two (2.1%) of the 94 unoperated controls, had vacuolated foveolar cells. The vacuolization is apparently not related to the patients' sex, and it seems to develop some years following gastric resection. Since both human and experimental studies have demonstrated that the duodenogastric reflux is more frequent in Billroth II than in Billroth I operated stomachs, it appears that subnuclear vacuolization in foveolar gastric cells is a histological marker for protracted duodenogastric reflux.