Clinical Gastroenterology Vol.24 No.10(5)

Theme Re-thinking Chromoendoscopy
Title Endoscopic Diagnosis of Gastric Neoplasms with Acetic Acid:Dynamic Chemical Endoscopy
Publish Date 2009/09
Author Kazuyoshi Yagi Department of Internal Medicine, Niigata Prefectural Yoshida Hospital
Author Toshifumi Sato Department of Internal Medicine, Niigata Prefectural Yoshida Hospital
Author Atsuo Nakamura Department of Internal Medicine, Niigata Prefectural Yoshida Hospital
Author Atsuo Sekine Department of Internal Medicine, Niigata Prefectural Yoshida Hospital
[ Summary ] Instillation of acetic acid gives the gastric mucosa a whitened appearance. The acetic whitening disappears in cancerous areas more quickly than in the non-cancerous areas. Although the acetic whitening of cancerous areas disappears early, the acetic whitening of non-cancerous area continues. Thus, the distinct contrast between cancerous areas and non-cancerous area can be observed with endoscopy. This method is termed dynamic chemical endoscopy. After instillation of acetic acid, adding of indigocarmine produces further areas of distinct contrast between cancerous areas and non-cancerous areas, when the cancerous areas are stained with indigocarmine, although non-cancerous areas are not stained. This method produces what is known as an acetic acid indigocarmine sandwich. The overall term for these techniques is chemical chromoendoscopy.
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