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The Old Endoscopy Quiz (and Answer) of the Month
August 2002

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Question:

Click on an image to get a magnification!

The summer of this year is here - at least on our half of the globe. During the summer - in June, July and August - the Quiz will be quite easy for two reasons. First, a quick answers save You time to be out in the sun. Second, You do not have to be an expert in endoscopy to manage in this quiz during the summer. So - if You are a health care professional just thinking of starting a career in endoscopy, please have a try - You might find it interesting!

In 1994 a new scientifically validatet classification of reflux oesophagitis was presented at the World Congress of Gastroenterology, hence the name LA Classification. According to this endoscopic grading system the severity of the oesophagitis is divided into four grades, Grade A, Grade B, Grade C and Grade D. Since 1994 this classification has been videly accepted and used by endoscopists over the world.

The images above represents a typical grade ? reflux oesophatis - well, what grade?

Answer

Reflux oesophagitis grade D according to the LA-classification.

The Los Angeles Classification System for the endoscopic assessment of reflux oesophagitis:
GRADE A: One or more mucosal breaks no longer than 5 mm, non of which extends between the tops of the mucosal folds
GRADE B: One or more mucosal breaks more than 5 mm long, none of which extends between the tops of two mucosal folds
GRADE C: Mucosal breaks that extend between the tops of two or more mucosal folds, but which involve less than 75% of the oesophageal circumference
GRADE D: Mucosal breaks which involve at least 75% of the oesophageal circumference


Grade A

Grade B

Grade C

Grade D
The majority of this months answers was grade D. However, about 25% answered grade C, and they might not be wrong, but we think this is grade D. These classifications are not always quite easy!

Correct answers and comments were emailed by

    Peeter Kõiva, Tartu, Estonia
    Ervin Toth, Malmö, Sweden
    Yekta Kisioglu, Istanbul, Turkey
    Claudia Ludwig, Vienna, Austria
    Tobias Gyarfas, Bonn, Germany
    ILKER ABCI, EDÝRNE, TURKEY
    Uma, chennai, Tamil Nadu, India
    LUISGUILLERMOGUERRERO, BOGOTA, COLOMBIA
    Çetin Karaca, Ýstanbul, Turkey
    Kubilay Cinar, Ankara, Turkey
    Elie Choueiry, Beirut, Lebanon
    Massimo Picasso, SAN REMO, ITALY
    isil tuzcuoglu, manisa, Turkey
    fahri akyuz, batman, turkey
    atakan sezer, edirne, turkey
    murat toruner, ankara, turkey

Beirut, Lebanon
    Zahreddine Radwan, Beirut, Lebanon


    Turkey
    Serkan, SARIKAYA, Edirne/TURKEY
    Charles Dyer, DO, Somerset, USA
    Christian Nielsen, Vasa, Finland
    Lankarani, Shiraz, Iran
    Arber Veliu, Prishtina, Yugoslavia
    irfan soykan, Ankara, Turkey
    BIDYUT GUHA, DHANBAD, JHARKHAND INDIA

    Comments:

    Grade C, because serious sitructure is not seen

    great site! keep up the good work, greetings from Holland!

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