Chromogastroduodenoscopy in Diagnostics of Ulcerative Lesions in Patients with Cardiovascular Pathology in Anemia

Abstract

Rationale. Standard esophagogastroduodenoscopy does not always detect ‘plain’ defects of mucosa with fibrin in comorbid patients with anemia. It is known that irrigation of gastric mucosa with methylene blue solution makes the relief more distinct.

Objective: to improve imaging of acute plain ulcers at anematized mucosa of stomach and duodenum using chromogastroduodenoscopy with methylene blue solution.

Methods. Chromogastroduodenoscopy with 0.25% and 0.5% methylene blue solution was used in 28 patients (aged 53–86; 17 (60.7 %) women, 11 (39.3 %) men) hospitalized for acute and chronic cardiovascular pathology in anemia. The endoscopic examination was carried out in reanimation or intensive care units. The exclusion criterion was the patient’s refusal to participate in the study. The key outcome was identification of mucosa defects (erosion, ulcer).

Results. Chromastroduodenoscopy with methylene blue allowed correct diagnosing of 5 patients (17.8 %) in which pathological processes could not be verified without contrasting. Improved visualization of mucosal defects during contrasting was obtained due to the following:

– the colorant spreading over the surface of the mucous accumulates in folds and grooves, erosions, ulcers, thereby showing the configuration;

– in stomach methylene blue does not color normal mucosa, but colors fibrin in the base of the defect. And in duodenum it colors mucosa and fibrin in the base of the ulcerative defect, while the edges of the defect are colored unevenly and are visualized as a rim during the imaging. No side effects were identified in the course of chromogastroduodenoscopy with methylene blue.

Conclusion. Chromogastroduodenoscopy with methylene blue is of great practical importance, being an informative and simple method.