胃鏡檢查結果分析及治療建議-肝膽腸胃科

上消化道泛內視鏡檢查結果？

[第一次胃鏡Finding]:(Esophagus)：mucosab break at EC junction less than 5mm(Stomach):CLO test was done. Hyperemic mucosa chanage at antrum shallow Gu at antrum s/p (Duodenum)：narrowing lumen at inferior duodenal angle of duodenum, suspect external compression related, cause?(Diagnosis)：1.Reflux Esophagitis, LA Grade （A）（No Biopsy )2.Superficial Gastritis （ No Biopsy )3.Gastric Ulcer （ Biopsy Was Done )Others : narrowing lumen at inferior duodenal angle of duodenum, suspect external compression related, cause?(Suggestions)：PPI treatment pending pathology report / GI OPD follow up(切片檢查)The specimen submitted consists of a tissue fragment measuring 0.2 x 0.1* 0. 1 cm. in size, fixed in formalin.Grossly, it is tan and elastic. All for section.Microscopically, the sections show a picture of chronic gastritis. No evidence of malignancy.Checklist of gastritis1. Neutrophils activity: Absent.Chronic inflammation/Mononuclear cells infiltration: Mild.3. Atrophy of glands: Absent4.Intestinal metaplasia: Absent.5.Helicobacter-like microorganism: Not identified.[第二次胃鏡Finding]:(Esophagus): sliding hiatal hernia with mucosal breaks at L/3 ＞ 5 mm with confluence ＜ 75 ％ circumference(Stomach):Gastric shallow ulcers,H1 s/p biopsyx 2 for path . hyperemia noted at antrum;CLO test was done to prepyloric area(Duodenum): Negative of bulb and 2nd portion[Diagnosis]:1.GERD Gr C with H.H R/o hoase shade gastal type2.EC junction s/p adhesion relaxation Gastritis, antrum3.Gastric multiple round ulcers,H1 s/p biopsyx 2 for path with hematin .4.Duodenalitis[Recommendation] 1. PPI tx, RAC tx if positive CLO test 2. GI OPD f/u .想詢問醫生,第一次胃鏡完目前已服用Nexium Tab 40mg 一個月+Pariet EFC Tab 20 mg半個月!但第二次胃鏡結果卻從GERD 卻從GERD Gr A變 Gr C,是不是還需要再注意什麼?另外想詢問hoase shade gastal type 代表的意義是? RAC tx 是指抗生素治療嗎?