Diagnostic accuracy of cascade stomach by upper gastrointestinal endoscopy in patients with obscure symptoms: a multi-center prospective trial.

AIM: Cascade stomach (CS) is a deformity of stomach, capable of leading dyspepsia, and its actual incidence is unknown. We investigated its frequency and performed a preliminary study to determine endoscopic diagnostic criteria. MATERIAL AND METHODS: One thousand four hundred and seventy-five consecutive patients were enrolled to this study. A criteria for CS in endoscopy was defined as follow: A fundal pouch after cardia, difficulty in passage from fundus to corpus and/or requiring a manoeuvre, an angulation separating fundus-corpus. Cases having all three criteria were considered as complete CS (CCS) only the third one as borderline CS (BCS). RESULTS: CS was diagnosed endoscopically in 33 (2.5%) and radiologically in 32 (2.4%) of patients with dyspepsia. Among endoscopically diagnosed CS patients, CCS was found to be present in 17 and BCS was found to be in 16 patients. Patients in whom CS was diagnosed endoscopically, radiological examination revealed CCS in 18 patients, BCS in 14 patients, and 1 patient with normal findings were detected. There were no significant differences between these two groups (P=0.559). CONCLUSION: CS can be presented with various upper abdominal symptoms, and it can easily be diagnosed when endoscopic criteria are considered.