Defining the Position of the Right Wall of the Esophageal Hiatus to Identify the Circumferential Distribution of Small Lesions of the Lower Esophagus

Background: The reliability of methods for identifying the circumferential position small lower esophageal lesions is unknown. We prospectively investigated a new method that presents lesion positions as times on clock face. Methods: Eighty-seven patients were consecutively examined by endoscopy. After observing esophagus, an endoscope was inserted into stomach and fixed, greater curvature folds at upper gastric corpus set horizontal monitor display. scope retrogressed esophagus. At this point, right wall hiatus 3 o'clock (R-line). then from angle to cardia along center lesser in retroflexed view obtain LC-line (the cardia). frontal identified, between R- LC-lines (R-LC) measured. Results: excluding 7 with hernias >2 cm stenosis, data 77 analyzed. R-LC ranged −38° +35°. mean −0.3°± 15.9°, its 95% confidence interval [−4.0°, 3.3°] within [−15°, + 15°]. When indicating locations face, there error ±30 min (±15°); therefore, shown be identical equivalence test. Conclusions: This allows reliably represented