Diagnosis of gastritis: A review and a report of the use of blind biopsy

IF GASTRITIS is considered to be an inflammatory process and we accept the probability that 3 per cent of the adult population suffer from it, we may understand the value of separating the problem from that of the diffuse processes of the stomach, in order to delineate the state of knowledge of the subject. In this paper, we review the developments that have led to the present knowledge of the condition, and we report a study of 500 blind biopsies. REVIEW OF THE LITERATURE In 1943 Schindler 1 said that the histologic changes of gastritis were well established and that they could be appraised by means of gastroscopy. However, at that time, opinions in the United States differed. They may be summarized as follows. 2, a The common types of gastritis histologically confirmed and observed over the course of seve al years were thought to include: phlegmonous gastritis; acute and suba~ute ulcerative gastritis caused by gastroduodenal ulcers; hemorrhagic aml toxic gastritis; atrophic gastritis due to pernicious anemia or sprue; atrophy and hypertrophy due to circulatory, hepatic, and pulmonary diseases; gastritis associated with disorders of the endocrine system; local chronic primary gastritis; hypertrophic gastritis (simulating carcinoma) ; and diffuse postoperative gastritis. Eusterman a brought an end to the use of" this classification, noting that knowledge was incomplete and that many problems of classification awaited solution and discussion. Such authors as Mc Glone 4 encountered gastritis in 3.9 per cent of 474 patients, while Gold a found endoscopic abnormalities diagnosed as gastritis in 18 of 50 soldiers, a 36 per cent incidence. Gordon 6 stated that in many instances, gastritis seems to be incidental to the course of gastrointestinal neuroses, that is to say, a re