Barrett's Syndrome:Morphological and Physiological Characteristics

The morphological and physiological characteristics in five cases of Barrett's syndrome are described. All the patients had a stricture at the junction between the two types of epithelium as well as hiatal hernia with reflux. In addition, three patients had ulcers in the area lined with columnar epithelium. The epithelium distal to the stricture was studied by light microscopy in all 5 cases and by electron microscopy in one. No parietal or main cells were demonstrated, but the surface epithelium showed the same characteristics as the surface epithelium in the stomach. Electron microscopy disclosed two types of granulated cells, which have so far been detected only in the stomach. It is concluded, therefore, that the oesophageal mucosa was of the same type as in the cardia. A finding of particular interest was granulated cells of type G, showing the same electron microscopic characteristics as the gastrin-producing cells in the stomach. In one case manometry was used as a diagnostic aid. This procedure must be considered a valuable supplement to cinematographic X-ray examination and oeso-phagoscopy. This applies especially in differentiating between cases of Barrett's syndrome with low stenosis and cases of hiatal hernia with oesophagitis and stricture, but without abnormal epithelial lining.