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Thread: "Patulous" eg junction

  1. #1
    Join Date
    Dec 2007
    Location
    Seattle, WA
    Posts
    436

    "Patulous" eg junction

    Are there any astute gerders on the board who can clue me in to "patulous eg junction"?

    I've had 3 scopes in my life: 1997; 2007, & 2009. Every one has been noted as "patulous eg junction". The photos I received this time however, showed my sphincter looking like a tightly puckered well...sphincter. My gi's assistant said maybe that's just the way I'm built. Anyways, I know that "patulous" means OPEN. And yet my photos show a tightly closed sphincter. So, is what's open, the "eg junction", not the "sphincter"? In other words, is there a distinction between the eg junction and the sphincter?? Forgive me but in spite of my having attended this board for 1 or 2 years or whatever, anatomy is still an area of challenge for me. Any clarification on this point would be greatly appreciated. I will seek clarification when I follow up with my gi in a couple weeks in any case, but I wanted to throw this question out there in the meantime.

  2. #2
    Join Date
    Jan 2003
    Location
    SE Wisconsin
    Posts
    1,678
    Patulous does mean open. My first Endoscopy indicated that my sphincter was 'patulous'.
    With the same notation on each EGD, I would think you would have already asked your doctor?????????

  3. #3
    Join Date
    Jan 2003
    Location
    Montreal
    Posts
    4,216

    Mark

    Hi Mark They use the terms patulous LES---- patulous cardia ---patulous EG junction . They all mean the very same thing .

    You can't see the LES Mark . not with a scope or naked eye . It's a pressure zone . It's invisable . It is the opening basically they are talking about. . It refers to the anatomy in the GE junction region that protects us from reflux . It's the lesser curvature component of the cardia actually if we want to get technical . When the scope is retroflexed you sometimes see a gaping there , that would be called a patulous cardia ... patulous LES .... GE junction whatever . All 3 terms are used for the same thing.

    Actually Hill quantified it more specifically coming up with a flap valve grading system from grade 1 to 4 [url]http://www.heartburn-help.com/hill1994.htm[/url] These pics will help you understand

    What does it mean for you ? It doesn't guarantee reflux , makes you more prone , makes the odds better . You need to back it up with a manometry and ph test ... alone it really means nothing . People without GERD and who have no symptoms can have a patulous GE junction too.

    Actually we have had people who have had it on one scope and not on the next . Sometimes the air from the scope or when you start retroflexing the scope can make it look patulous , or if you have a peralisistic wave .

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