In the Helicobacter pylori-negative normal stomach there are a "regular arrangement of collecting venules" (RAC) visible.
In this study, investigators from Japan assessed the reliability of using the RAC pattern to discriminate normal gastric mucosa from H. pylori gastritis in pediatric patients.
The team included 52 consecutive children, adolescents and young adults who were referred for endoscopy and assessed for H. pylori infection.
|Absence of the RAC pattern should prompt gastric mucosal biopsies.|
They evaluated the lower lesser curvature of the corpus near the incisura for the RAC pattern using a standard endoscope with the tip close to, but not in contact with, the gastric surface.
Gastric biopsies were taken after the endoscopic observation.
The investigators found 29 RAC-positive patients. In all these patients active H. pylori gastritis was absent.
In addition, the team found H. pylori gastritis in 87% of the RAC-negative patients.
Dr Yoshiko Nakayama's team concluded, "The RAC pattern…proved to be an effective and practical marker to discriminate normal histology from H. pylori gastritis among both children and young adults".
"Absence of the RAC pattern should prompt gastric mucosal biopsies despite otherwise normal-appearing gastric mucosa".