Detection of palisade vessels as a landmark for Barrett’s esophagus in a Western population

Dirk W. Schölvinck, Osamu Goto, Cornelis A. Seldenrijk, Raf Bisschops, Joichiro Horii, Yasutoshi Ochiai, Erik J. Schoon, Boudewijn E. Schenk, Toshio Uraoka, Martijn G H van Oijen, Jacques J G H M Bergman, Naohisa Yahagi, Bas L A M Weusten

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Background: In Japan, palisade vessels (PV) are used to distinguish the esophagogastric junction (EGJ). Elsewhere, the EGJ is defined by the upper end of the gastric folds (GF) and PV are considered difficult to detect. This study evaluated the detection rate of PV in Western patients with Barrett’s esophagus (BE) using white light imaging (WLI) and narrow band imaging (NBI), and quantified any discordance between Western and Japanese criteria for the EGJ. Methods: In 25 BE patients, the presence and location of PV and GF were determined and biopsies were obtained. High-quality images of the EGJ were collected under different conditions (insufflations–desufflation, WLI–NBI, forward-retroflex approach), resulting in eight different images per patient. The presence of PV on each still image was assessed by a panel of six Western and Japanese endoscopists with expertise in BE. Results: PV were observed in ≥ 1 images by a majority of the panel (≥ 4 raters) in 100 % of patients during insufflation versus 60 % during desufflation (p <0.001). WLI and NBI detected PV in 100 and 92 %, respectively (p = 0.50). Interobserver agreement of the panel was ‘moderate’ (κ = 0.51). During endoscopy PV were located a median of 1 cm distal of the GF in 15 patients (63 %), with intestinal metaplasia (IM) in this discordant zone, in 27 % of patients. Conclusions: PV are visible in most Western BE patients and are best inspected during insufflation. The location of the GF and PV differed in a substantial group of patients, partially with IM in this discordant zone.

Original languageEnglish
JournalJournal of Gastroenterology
Publication statusAccepted/In press - 2015 Nov 4


  • Barrett’s esophagus
  • Esophagogastric junction
  • Gastric folds
  • Palisade vessels

ASJC Scopus subject areas

  • Gastroenterology


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