array:24 [ "pii" => "S2387020615002831" "issn" => "23870206" "doi" => "10.1016/j.medcle.2015.12.018" "estado" => "S300" "fechaPublicacion" => "2015-05-21" "aid" => "3170" "copyright" => "Elsevier España, S.L.U.. All rights reserved" "copyrightAnyo" => "2014" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Clin. 2015;144:470-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 63 "formatos" => array:2 [ "HTML" => 59 "PDF" => 4 ] ] "Traduccion" => array:1 [ "es" => array:18 [ "pii" => "S0025775314008215" "issn" => "00257753" "doi" => "10.1016/j.medcli.2014.11.007" "estado" => "S300" "fechaPublicacion" => "2015-05-21" "aid" => "3170" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "subdocumento" => "crp" "cita" => "Med Clin. 2015;144:470-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 870 "formatos" => array:2 [ "HTML" => 834 "PDF" => 36 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Diagnóstico y tratamiento</span>" "titulo" => "Pliegues gástricos engrosados: diagnóstico diferencial" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "470" "paginaFinal" => "474" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Large gastric folds: Differential diagnosis" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 773 "Ancho" => 995 "Tamanyo" => 103537 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Lesión subepitelial gástrica recubierta por mucosa de aspecto normal. La biopsia guiada por ecoendoscopia fue diagnóstica de tumor del estroma gastrointestinal.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana García García de Paredes, Javier Martínez González, Laura Crespo Pérez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Ana" "apellidos" => "García García de Paredes" ] 1 => array:2 [ "nombre" => "Javier" "apellidos" => "Martínez González" ] 2 => array:2 [ "nombre" => "Laura" "apellidos" => "Crespo Pérez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2387020615002831" "doi" => "10.1016/j.medcle.2015.12.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020615002831?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775314008215?idApp=UINPBA00004N" "url" => "/00257753/0000014400000010/v2_201505051026/S0025775314008215/v2_201505051026/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2387020615002971" "issn" => "23870206" "doi" => "10.1016/j.medcle.2015.12.032" "estado" => "S300" "fechaPublicacion" => "2015-05-21" "aid" => "3086" "copyright" => "Elsevier España, S.L.U." "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Clin. 2015;144:475-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 23 "formatos" => array:2 [ "HTML" => 17 "PDF" => 6 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Patient involvement in the hygiene of our hands, a topic to debate?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "475" "paginaFinal" => "476" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Implicación del paciente en la higiene de nuestras manos, ¿un tema a debate?" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Juan Rodríguez-García, Rafael Fernández-Santos, María Luz Fernández-Núñez, Verónica Brugos-Llamazares" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Juan" "apellidos" => "Rodríguez-García" ] 1 => array:2 [ "nombre" => "Rafael" "apellidos" => "Fernández-Santos" ] 2 => array:2 [ "nombre" => "María Luz" "apellidos" => "Fernández-Núñez" ] 3 => array:2 [ "nombre" => "Verónica" "apellidos" => "Brugos-Llamazares" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775314005843" "doi" => "10.1016/j.medcli.2014.06.016" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775314005843?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020615002971?idApp=UINPBA00004N" "url" => "/23870206/0000014400000010/v1_201601310051/S2387020615002971/v1_201601310051/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2387020615003034" "issn" => "23870206" "doi" => "10.1016/j.medcle.2015.12.038" "estado" => "S300" "fechaPublicacion" => "2015-05-21" "aid" => "3140" "copyright" => "Elsevier España, S.L.U." "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Clin. 2015;144:465-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 43 "formatos" => array:2 [ "HTML" => 38 "PDF" => 5 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Special article</span>" "titulo" => "Storage of human samples for research: Autonomy and genomic data" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "465" "paginaFinal" => "469" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Almacenamiento de muestras humanas aptas para investigación: autonomía y datos genéticos" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "<span class="elsevierStyleItalic">Source</span>: García del Pozo et al.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">9</span></a>" "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2010 "Ancho" => 2936 "Tamanyo" => 333362 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sample usage system established by Royal Decree 1716/2011. Biobank CEExt: Biobank External Ethics Committee; REC: Research Ethics Committee.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Concepción Martín-Arribas, Emma Fernández-de Uzquiano, Leyre de Sola Perea, Javier Arias-Díaz" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M. Concepción" "apellidos" => "Martín-Arribas" ] 1 => array:2 [ "nombre" => "Emma" "apellidos" => "Fernández-de Uzquiano" ] 2 => array:2 [ "nombre" => "Leyre" "apellidos" => "de Sola Perea" ] 3 => array:2 [ "nombre" => "Javier" "apellidos" => "Arias-Díaz" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775314007465" "doi" => "10.1016/j.medcli.2014.09.022" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775314007465?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020615003034?idApp=UINPBA00004N" "url" => "/23870206/0000014400000010/v1_201601310051/S2387020615003034/v1_201601310051/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Diagnosis and treatment</span>" "titulo" => "Large gastric folds: Differential diagnosis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "470" "paginaFinal" => "474" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ana García García de Paredes, Javier Martínez González, Laura Crespo Pérez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Ana" "apellidos" => "García García de Paredes" "email" => array:1 [ 0 => "anaggparedes@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Javier" "apellidos" => "Martínez González" ] 2 => array:2 [ "nombre" => "Laura" "apellidos" => "Crespo Pérez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pliegues gástricos engrosados: diagnóstico diferencial" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 773 "Ancho" => 995 "Tamanyo" => 106297 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Gastric subepithelial lesion covered by normal-looking mucosa. The ecoendoscopy-guided biopsy helped diagnose a gastrointestinal stromal tumour.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Large gastric folds: differential diagnosis</span><p id="par0005" class="elsevierStylePara elsevierViewall">The gastric mucosa presents mucosal folds in the fundus that extend longitudinally along the gastric body to the antrum, where they become flat. In the presence of thickened gastric folds, two factors need to be assessed: subjectivity and degree of air insufflation. Various conditions are associated with gastric fold thickening. To facilitate their study, these are divided into: (1) hyperplastic gastropathies, in which there is an increase in the number of oxyntic gland cells; and (2) non-hyperplastic gastropathies (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Hyperplastic gastropathies</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Ménétrier's disease</span><p id="par0010" class="elsevierStylePara elsevierViewall">This rare disease, also known as hyperplastic hypersecretory gastropathy or protein-losing enteropathy, is of unknown prevalence and more commonly affects middle-aged male patients.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Its aetiology is unknown. The cytomegalovirus (CMV) seems to be responsible for the disease in children,<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">1,2</span></a> while in adults it is associated with other microorganisms, apart from CMV, such as <span class="elsevierStyleItalic">Helicobacter pylori (H. pylori)</span>, herpes simplex virus and <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span>; it has even been related with ulcerative colitis.<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">3–6</span></a> In all cases, <span class="elsevierStyleItalic">H. pylori</span> should be ruled out and, at least in children, CMV should also be discounted. The pathogenic mechanism is an increase in the transforming growth factor α (TGF-α) and activation of the epidermal growth factor receptor (EGFR), which results in a proliferation of mucosal cells from the gastric body and fundus.<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">7,8</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">From a clinical point of view, it may cause abdominal pain, hyporexia, vomiting, digestive haemorrhage or diarrhoea.<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">8</span></a> Hypoproteinaemia or hypoalbuminaemia without urine protein should be considered possible indicators of the disease. This alteration is due to the loss of proteins through the gastric mucosa, which may lead to oedema, ascites, pleural or pericardial effusion. In children, the disease appears around the age of 3, is of sudden onset and causes intense vomiting and generalised oedema; but the prognosis is good, with spontaneous resolution in weeks.<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">1,2</span></a> However, in adults it is chronic. It is characterised by an alkaline pH during gastric aspiration due to the action of the TGF-α, which reduces gastric acid secretion. The malignancy risk of Ménétrier's disease (ME) is a controversial subject.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">9</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The endoscopy shows enlarged, tortuous, cerebriform-like folds in the fundus and in the major curve of the gastric body, the antrum generally being preserved (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The ecoendoscopy shows thickening only of the first 2 layers of the gastric wall (superficial mucosa and deep mucosa with <span class="elsevierStyleItalic">muscularis mucosae</span>).<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">9–11</span></a> Macrobiopsies with macro forceps or polypectomy snares are recommended so as to include <span class="elsevierStyleItalic">muscularis mucosae</span>.<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">11</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The histological study is not pathognomonic. ME is characterised by diffuse foveolar hyperplasia, tortuous-like gland proliferation with cystic dilations and loss of parietal and main cells, which are replaced by mucosal cells. The lamina propria may contain a mild inflammatory infiltration.<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">8,9</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Treatment should consider nutritional supplements, a hyperproteic diet, intravenous albumin or diuretics. In children, due to its self-limited progression, conservative treatment is usually enough, and ganciclovir is considered in severe cases of more than two weeks duration, immunosuppressed patients or newborns.<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">12</span></a> In adults, <span class="elsevierStyleItalic">H. pylori</span><a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">13</span></a> eradicating treatment is indicated. If the disease continues, the typical treatment is surgery (total gastrectomy or sub-total gastrectomy with preservation of the antrum), since it also eliminates the risk of potential malignisation. However, the discovery of various medical treatments has made it possible to reserve surgery for refractory cases. The disease has been treated with H2 receptor antagonists, proton pump inhibitors (PPI), anticholinergics, somatostatin analogues (octreotide)<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">14,15</span></a> and anti-EGFR monoclonal antibodies (cetuximab). Though there are doubts about the actual efficiency of each of these treatments, it seems reasonable to consider them before surgery. Of these treatments, those with most recent evidence are octreotide and cetixumab—the latter giving promising results.<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">15–17</span></a> If a medical treatment is chosen, given the controversy regarding the risk of gastric cancer, an endoscopic follow-up is recommended.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Zollinger–Ellison syndrome</span><p id="par0040" class="elsevierStylePara elsevierViewall">This is characterised by very high gastrin levels<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">18</span></a> resulting from functioning neuroendocrine tumours (gastrinomas) which are usually located in the gastrinoma triangle that comprises the duodenum, pancreas and adjacent lymph nodes.<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">19</span></a> The sporadic form is found in 80% of patients and is usually diagnosed in the fifth decade of life. In the remaining 20% of patients it is part of the multiple endocrine neoplasia type 1 (MEN-1) syndrome, which also presents parathyroid and pituitary tumours; diagnosis usually occurs in younger patients.<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">19</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The clinical manifestations include those resulting from gastric acid hypersecretion: multiple and recurrent ulcers located in the duodenal bulb in 75% of patients, though they may be located in other uncommon areas<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">19</span></a>; peptic oesophagitis, which can be very severe and is one of the causes of “black oesophagus”; and diarrhoea due to the inactivation of pancreatic enzymes and damage to intestinal villi.</p><p id="par0050" class="elsevierStylePara elsevierViewall">If diagnostic suspicion exists, serum gastrin must be determined in a fasting state, and PPI should be withdrawn 3–7 days earlier. Slightly elevated serum gastrin levels (>110<span class="elsevierStyleHsp" style=""></span>pg/ml) are not sensitive and specific enough. However, gastrin figures above 1000<span class="elsevierStyleHsp" style=""></span>pg/ml, in the presence of acid gastric pH, practically determine the diagnosis.<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">20</span></a> If, on gastrin determination, doubts about diagnosis remain, the secretin stimulation test helps distinguish this syndrome from other causes of hypergastrinaemia, so gastrin figures above 200<span class="elsevierStyleHsp" style=""></span>pg/ml post-stimulation have 83% sensitivity and 100% specificity for the diagnosis of gastrinoma.<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">20</span></a> Radiological (computed tomography, magnetic resonance imaging and octreoscan) and endoscopic techniques (ecoendoscopy) permit local and distance assessment. MEN-1 syndrome should be ruled out in young patients with a family history or other manifestations, such as hyperparathyroidism.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The treatment of Zollinger–Ellison syndrome includes: (a) treatment of functional syndrome, for which the development of acid antisecretory agents has significantly reduced the morbidity and mortality of the ulcerative disease. High PPI doses are recommended, and these are adjusted on the basis of the clinical activity and cicatrisation of ulcers<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">19</span></a>; and (b) treatment of the tumour: if the tumour is localised and has no distant dissemination, then surgical resection is curative in 50% of cases, with an 80% chance of survival at 10 years. However, only 30% of gastrinomas meet removal criteria on diagnosis.<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">21</span></a> MEN-1 syndrome gastrinomas have no clear surgical indication given that they are multifocal and present high recurrence rates. If metastasis exists, there are several options: octreotide, hepatic lesion resection, artery embolisation with or without chemotherapy infusion, radiofrequency or systemic chemotherapy, which lead to 30% survival at 10 years.<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">19,21</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Hyperplasia of parietal and enterochromaffin cells secondary to proton pump inhibitors</span><p id="par0060" class="elsevierStylePara elsevierViewall">PPIs block the H<span class="elsevierStyleSup">+</span>-K<span class="elsevierStyleSup">+</span>ATPase pump of parietal cells, thus reducing gastric acid production. This hypochlorhydria stimulates the secretion of gastrin, which has a considerable trophic effect on parietal cells, resulting in gastric fold thickening. The trophic effect also affects enterochromaffin cells of the gastric fundus and body, which may result in a gastric carcinoid tumour.<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">22</span></a> This can be distinguished via the history of continued PPI consumption and a compatible histology (increased number of parietal cells, sometimes with protrusion into the gland lumen and dilation of oxyntic glands without foveolar hyperplasia<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">9</span></a>). The suspension of PPIs normalises the gastric mucosa hystology.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Non-hyperplastic gastropathies</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Infections</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Gastritis by <span class="elsevierStyleItalic">Helicobacter pylori</span></span><p id="par0065" class="elsevierStylePara elsevierViewall">Infection caused by <span class="elsevierStyleItalic">H. pylori</span> has high prevalence and affects more than 50% of the population although this varies from one country to another.<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">23</span></a> It is the most common cause of gastric mucosa thickening.<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">24</span></a> The histological study shows bacilli on the mucous surface and an intense infiltration of polymorphonuclear cells, and plasma lymphocytes and cells in the acute and chronic forms, respectively. In both forms, eradication of <span class="elsevierStyleItalic">H. pylori</span> is indicated and this normalises the mucosa.<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">25</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Other less common microorganisms may affect the gastric mucosa:</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Syphilis</span><p id="par0075" class="elsevierStylePara elsevierViewall">Gastritis by lues is typical of secondary syphilis but is rare (<1%) and presents non-specific clinical activity. The antrum is the most commonly affected area.<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">26</span></a> Biopsies show lymphoplasmacytic infiltration and, occasionally, perivascular changes or endarteritis, all of which are non-specific. A high level of suspicion must exist and it must be present in the differential diagnosis of thickened gastric folds, particularly if this affects the antrum. Treatment with penicillin is curative.<a class="elsevierStyleCrossRefs" href="#bib0340"><span class="elsevierStyleSup">26,27</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Tuberculosis</span><p id="par0080" class="elsevierStylePara elsevierViewall">A tuberculosis gastric condition is rare and affects patients with immunosuppression and those with concomitant pulmonary disease.<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">28</span></a> The clinical onset most frequently takes the form of a gastric obstruction. The endoscopic image may look like a peptic ulcer or malign neoplasia. Biopsies show caseating granulomas and, occasionally, acid-alcohol resistant bacilli.<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">28</span></a> Treatment with antituberculosis drugs resolves the symptoms.</p><p id="par0085" class="elsevierStylePara elsevierViewall">Other infections that may occur together with thickened gastric folds, particularly in immunosuppressed patients, are cryptococcosis, histoplasmosis or aspergilosis.</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Neoplasia</span><p id="par0090" class="elsevierStylePara elsevierViewall">In the presence of thickened gastric folds, malignancy, mainly adenocarcinoma and gastric lymphoma, must be ruled out. Small, distensible, rigid folds, with masses or ulcers, and disease in several layers in the ecoendoscopy lead to the suspicion of a malignant aetiology.<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">29</span></a></p><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Gastric adenocarcinoma</span><p id="par0095" class="elsevierStylePara elsevierViewall">This usually manifests late with abdominal pain and weight loss. From a macroscopic point of view, it presents as mamelonated lesions, friable to the touch and ulcerated. The diagnosis is confirmed by histological assessment of the lesion.<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">24</span></a> A particularly aggressive variant of gastric cancer is the diffuse type or linitis plastica, characterised by reduced gastric distensibility and infiltration of the submucosal and muscularis propria layers. The mucosal epithelium is normal, which accounts for frequent false-negative results in conventional biopsies. In these cases, macrobiopsies or ecoendoscopies are required to confirm the diagnosis.<a class="elsevierStyleCrossRefs" href="#bib0330"><span class="elsevierStyleSup">24,29</span></a> After the extension study, the most adequate surgical and/or chemotherapy treatment is suggested.</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Gastric lymphoma</span><p id="par0100" class="elsevierStylePara elsevierViewall">The stomach is the most common extra-lymph-node location of lymphomas. The most common is the B-cell non-Hodgkin lymphoma, which includes the large B-cell diffuse lymphoma and the mucosa-associated lymphoid tissue (MALT) lymphoma, accounting for 50% of gastric lymphomas.<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">30</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">The relation between the MALT lymphoma and <span class="elsevierStyleItalic">H. pylori</span> infection was discovered long ago. The MALT lymphoma is associated with non-specific dyspeptic symptoms, B-symptoms being exceptional. In the endoscopy, it most commonly affects the minor curve and may present erosion lesions, ulcers, gastric fold thickening, lymph node surface, petechial mucosal lesions, or a normal macroscopic appearance. Pathology shows dense lymphoid infiltration of small lymphocytes without a characteristic antigenic profile that invade and destroy gastric glands, generating a pathognomonic lymphoepithelial lesion.<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">30</span></a> In the early stages (I-II) of low grade MALT lymphoma, the eradication of <span class="elsevierStyleItalic">H. pylori</span> leads to 77% full remission, even in study cases with negative <span class="elsevierStyleItalic">H. pylori</span> results. Hence, an eradicating treatment is recommended, regardless of whether <span class="elsevierStyleItalic">H. pylori</span> is confirmed or not.<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">31,32</span></a> If remission is achieved, then a periodic endoscopic follow-up with multiple biopsies is necessary. In cases refractory to eradicating treatment, in high grade lymphomas and low grade lymphomas in advanced stages, the therapeutic options include chemotherapy with rituximab, radiotherapy and, sometimes, surgery.<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">31</span></a></p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Gastrointestinal stromal tumours</span><p id="par0110" class="elsevierStylePara elsevierViewall">Gastrointestinal stromal tumours (GIST) are the most common type of digestive tract mesenchymal neoplasia and the stomach is their most frequent location. These are caused by Cajal's interstitial cells, responsible for the regulation of the gastrointestinal autonomic nervous system.<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">33</span></a> Clinically, these tumours tend to be asymptomatic or present non-specific symptoms. Sometimes, they present superficial erosion lesions that may result in digestive haemorrhage and anaemia. In the endoscopy, they are shown as a subepithelial mass, generally over the gastric fundus, covered by normal-looking mucosa<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">8,33</span></a> (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). In general, superficial biopsies are not diagnostic, and an ecoendoscopy may be necessary to characterise the lesion more accurately and obtain samples. In the histological study, c-KIT (CD117) positive immunohistochemistry is characteristic in 95% of cases.<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">8,34</span></a> The mitotic index and tumour size predict its behaviour and prognosis. Physicians disagree over the therapeutic approach (observation vs treatment) to tumours <2<span class="elsevierStyleHsp" style=""></span>cm due to their low aggressiveness. In localised tumours >2<span class="elsevierStyleHsp" style=""></span>cm, the treatment of choice is surgical resection. Imatinib is used as a neoadjuvant and surgery adjuvant treatment, as well as in non-surgical cases. Other treatments (sunitinib, nilotinib, dasatinib) are also being assessed.<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">8</span></a></p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Miscellaneous</span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Amyloidosis</span><p id="par0115" class="elsevierStylePara elsevierViewall">The term “amyloidosis” refers to a group of diseases characterised by the extracellular deposit of protein fibrillar material. It may be hereditary or acquired, systemic or localised, and primary (AL forms due to blood dyscrasias, such as multiple myeloma) or secondary (AA forms in the context of chronic inflammatory diseases).<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">35</span></a> The gastric affection due to amyloid deposit generally occurs in systemic forms. AL forms affect deep mucosal layers and, therefore, present polypoid lesions; AA forms generally show a more granular appearance since the affection is more superficial.<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">35</span></a> Diagnosis is via characteristic histological findings: Congo red dye and presence of apple green birefringence under a polarised light microscope. AL forms are treated with chemotherapy whereas AA forms are treated by control of the underlying disease.<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">36</span></a></p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Sarcoidosis</span><p id="par0120" class="elsevierStylePara elsevierViewall">This is a granulomatous systemic disease of unknown cause. The gastric antrum is the area most frequently affected—during the course of the disease or as its first manifestation—generally in the form of abdominal pain.<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">37</span></a> Endoscopic findings are non-specific. Extra-gastric affection, mainly pulmonary, and the typical histology of non-caseating granulomas help distinguish it from other granulomatous diseases. Symptomatic treatment uses prokinetic agents or PPI but in highly symptomatic patients or those with a significant granulomatous affection, systemic corticosteroids should be considered.<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">37</span></a></p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Crohn's disease</span><p id="par0125" class="elsevierStylePara elsevierViewall">This is a chronic, idiopathic, inflammatory disease that can affect the digestive system from the mouth to the anus. Gastric affection seems more common than previously thought, affecting even asymptomatic patients.<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">38</span></a> From a clinical point of view, it can appear with peptic symptomatology or as an intestinal obstruction. The endoscopy shows a thickened, erythematous mucosa, with linear ulcers and sores, with greater affection at the level of the gastric antrum. Biopsies show abnormalities typical of Crohn's disease.<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">39</span></a> Treatment with PPI improves the symptomatology. Glucocorticosteroids, azathioprine or methotrexate may be needed, with anti-TNF being an alternative in cases of refractory disease.</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Eosinophilic gastroenteritis</span><p id="par0130" class="elsevierStylePara elsevierViewall">This is an inflammatory disorder of unknown aetiology but with a major allergic component, as it frequently presents high levels of IgE, as well as a history of asthma, food allergies, rhinitis or atopy. Symptoms are non-specific. 80% of patients present peripheral eosinophilia.<a class="elsevierStyleCrossRefs" href="#bib0410"><span class="elsevierStyleSup">40,41</span></a> Endoscopic findings show a thickened, polypoid or lymph node mucosa, mainly with antrum affection, all of which has a patch-like appearance. Hence, multiple biopsies are needed. Histology reveals an infiltration of eosinophils with no precise cut-off point for diagnosis, though the most consistent figure is more than 50 eosinophils per high-power field.<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">41</span></a> The differential diagnosis includes other causes of peripheral eosinophilia, such as parasitic infections, hypereosinophilic syndrome or Churg–Strauss syndrome. Given the allergic component, treatment usually focuses on food, with elemental or exclusion diets for a minimum of 6 weeks. In refractory cases, treatment is with systemic corticosteroids.<a class="elsevierStyleCrossRefs" href="#bib0410"><span class="elsevierStyleSup">40,41</span></a></p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Lymphocytic or varioliform gastritis</span><p id="par0135" class="elsevierStylePara elsevierViewall">This is a very rare form of gastritis, which may have a normal appearance or present a pattern known as “varioliformis”, with isolated lymph node mucosa protrusions.<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">38</span></a> Histologically, it is characterised by the presence of epithelial lymphocyte infiltration (>25 intraepithelial lymphocytes per 100 epithelial cells). The currently recommended treatment consists of PPI and the eradication of <span class="elsevierStyleItalic">H. pylori</span>.<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">38</span></a></p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Polyposis syndromes</span><p id="par0140" class="elsevierStylePara elsevierViewall">Several polyposis syndromes may affect the stomach. These result in the irregular thickening of the mucosa, which sometimes cannot be distinguished from other entities. Family history, genetic studies and the presence of extra-gastric manifestations, particularly of polyps in the bowel and/or colon, are essential for the differential diagnosis.<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">38</span></a> Among hereditary polyposis syndromes with gastric affection, we find familial adenomatous polyposis, which affects the stomach in more than 30% of patients, with 95% of the cases being related to fundic gland polyps.<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">42</span></a> Other inherited syndromes which may also present gastric affection are Gardner's syndrome, attenuated familial adenomatous polyposis, MUTYH-associated polyposis, Peutz–Jeghers’ syndrome (mucocutaneous hyperpigmentation and hamartomatous polyps along the digestive tract, affecting the stomach in 15–30% of cases<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">42</span></a>), as well as juvenile polyposis and Cowden's syndromes, which also present gastric hamartomatous polyps. Non-hereditary polyposis syndromes with gastric affection include Cronkhite–Canada's syndrome.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">9</span></a></p></span></span></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclusion</span><p id="par0145" class="elsevierStylePara elsevierViewall">In conclusion, a large number of proliferative, inflammatory, infectious and infiltrative processes may present thickened gastric folds. The broad differential diagnosis faced by the clinician who encounters this is complicated by the fact that many of these disorders are rare entities that require a high level of diagnostic suspicion. It is necessary to consider the clinical context of the patient, the symptomatology and the presence of extra-gastric manifestations as well as histological findings to provide an accurate diagnosis and treatment.</p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflict of interest</span><p id="par0150" class="elsevierStylePara elsevierViewall">The authors declare that there are no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0115" "titulo" => "Large gastric folds: differential diagnosis" ] 1 => array:3 [ "identificador" => "sec0005" "titulo" => "Hyperplastic gastropathies" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Ménétrier's disease" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Zollinger–Ellison syndrome" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Hyperplasia of parietal and enterochromaffin cells secondary to proton pump inhibitors" ] ] ] 2 => array:3 [ "identificador" => "sec0025" "titulo" => "Non-hyperplastic gastropathies" "secciones" => array:3 [ 0 => array:3 [ "identificador" => "sec0030" "titulo" => "Infections" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Gastritis by Helicobacter pylori" ] 1 => array:2 [ "identificador" => "sec0040" "titulo" => "Syphilis" ] 2 => array:2 [ "identificador" => "sec0045" "titulo" => "Tuberculosis" ] ] ] 1 => array:3 [ "identificador" => "sec0050" "titulo" => "Neoplasia" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0055" "titulo" => "Gastric adenocarcinoma" ] 1 => array:2 [ "identificador" => "sec0060" "titulo" => "Gastric lymphoma" ] 2 => array:2 [ "identificador" => "sec0065" "titulo" => "Gastrointestinal stromal tumours" ] ] ] 2 => array:3 [ "identificador" => "sec0070" "titulo" => "Miscellaneous" "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0075" "titulo" => "Amyloidosis" ] 1 => array:2 [ "identificador" => "sec0080" "titulo" => "Sarcoidosis" ] 2 => array:2 [ "identificador" => "sec0085" "titulo" => "Crohn's disease" ] 3 => array:2 [ "identificador" => "sec0090" "titulo" => "Eosinophilic gastroenteritis" ] 4 => array:2 [ "identificador" => "sec0095" "titulo" => "Lymphocytic or varioliform gastritis" ] 5 => array:2 [ "identificador" => "sec0100" "titulo" => "Polyposis syndromes" ] ] ] ] ] 3 => array:2 [ "identificador" => "sec0105" "titulo" => "Conclusion" ] 4 => array:2 [ "identificador" => "sec0110" "titulo" => "Conflict of interest" ] 5 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-11-04" "fechaAceptado" => "2014-11-20" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: García García de Paredes A, Martínez González J, Crespo Pérez L. Pliegues gástricos engrosados: diagnóstico diferencial. Med Clin (Barc). 2015;144:470–474.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 786 "Ancho" => 995 "Tamanyo" => 122024 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Thickened, tortuous gastric folds with oedematous and polypoid mucosa in a patient with Ménétrier's disease.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 773 "Ancho" => 995 "Tamanyo" => 106297 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Gastric subepithelial lesion covered by normal-looking mucosa. The ecoendoscopy-guided biopsy helped diagnose a gastrointestinal stromal tumour.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Hyperplastic gastropathies</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ménétrier's disease \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Zollinger–Ellison syndrome or gastrinoma \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hyperplasia of parietal and enterochromaffin cells secondary to the use of PPI \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleBold">Non-hyperplastic gastropathies</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Infections</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Gastritis by <span class="elsevierStyleItalic">Helicobacter pylori</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Other infections \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Syphilis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Tuberculosis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Cryptococcosis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Histoplasmosis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Aspergilosis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Neoplasia</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Gastric adenocarcinoma \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Gastric lymphoma \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Gastrointestinal stromal tumours \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Miscellaneous</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Amyloidosis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Sarcoidosis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Crohn's disease \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Eosinophilic gastroenteritis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Lymphocytic gastritis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Polyposis syndromes \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab983064.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Differential diagnosis of thickened gastric folds.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:42 [ 0 => array:3 [ "identificador" => "bib0215" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ménétrier's disease of childhood and acute cytomegalus virus infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Cardona Barberán" 1 => "A. Sorní Hubrecht" 2 => "A. Hostalot Abás" 3 => "J. Rosal Roig" 4 => "J. Mercé Gratacós" 5 => "J.A. Izuel Navarro" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ann Pediatr (Barc)" "fecha" => "2006" "volumen" => "64" "paginaInicial" => "478" "paginaFinal" => "480" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0220" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "CMV-associated protein-losing gastropathy in childhood" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "O. Megged" 1 => "Y. Schlesinger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00431-008-0791-1" "Revista" => array:6 [ "tituloSerie" => "Eur J Pediatr" "fecha" => "2008" "volumen" => "167" "paginaInicial" => "1217" "paginaFinal" => "1220" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18651176" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0225" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Healing of protein losing hypertrophic gastropathy by eradication of <span class="elsevierStyleItalic">Helicobacter pylori</span>: is <span class="elsevierStyleItalic">Helicobacter pylori</span> a pathogenic factor in Menetrier's disease?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Bayerdorffer" 1 => "M.M. Ritter" 2 => "R. Hatz" 3 => "W. Brooks" 4 => "G. Ruckdeschel" 5 => "M. Stolte" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Gut" "fecha" => "1994" "volumen" => "35" "paginaInicial" => "701" "paginaFinal" => "704" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8200570" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0230" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Menetrier's disease associated with herpes infection" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.W. Jun" 1 => "D.H. Kim" 2 => "S.H. Kim" 3 => "M.H. Song" 4 => "H.H. Lee" 5 => "S.H. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.gie.2006.11.003" "Revista" => array:6 [ "tituloSerie" => "Gastrointest Endosc" "fecha" => "2007" "volumen" => "65" "paginaInicial" => "1092" "paginaFinal" => "1095" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17531647" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0235" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transient protein-losing hypertrophic gastropathy associated with <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span> infection in childhood" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Ben Amitai" 1 => "I. Zahavi" 2 => "G. Dinari" 3 => "B.Z. Garty" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Pediatr Gastroenterol Nutr" "fecha" => "1992" "volumen" => "14" "paginaInicial" => "237" "paginaFinal" => "239" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1593380" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0240" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Menetrier's disease coexisting with ulcerative colitis and sclerosing cholangitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "I. Hatemi" 1 => "E. Caglar" 2 => "D. Aksoy" 3 => "S. Goksel" 4 => "A. Dobrucali" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.dld.2007.10.001" "Revista" => array:6 [ "tituloSerie" => "Dig Liver Dis" "fecha" => "2008" "volumen" => "40" "paginaInicial" => "78" "paginaFinal" => "79" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18037066" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0245" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Possible role of transforming growth factor alpha in the pathogenesis of Ménétrier's disease: supportive evidence form humans and transgenic mice" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.J. Dempsey" 1 => "J.R. Goldenring" 2 => "C.J. Soroka" 3 => "I.M. Modlin" 4 => "R.W. McClure" 5 => "C.D. Lind" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Gastroenterology" "fecha" => "1992" "volumen" => "103" "paginaInicial" => "1950" "paginaFinal" => "1963" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1451986" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0250" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ménétrier disease and gastrointestinal stromal tumors: hyperproliferative disorders of the stomach" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.J. Coffey" 1 => "M.K. Washington" 2 => "C.L. Corless" 3 => "M.C. Heinrich" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1172/JCI30491" "Revista" => array:6 [ "tituloSerie" => "J Clin Invest" "fecha" => "2007" "volumen" => "117" "paginaInicial" => "70" "paginaFinal" => "80" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17200708" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0255" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Distinguishing Ménétrier's disease from its mimics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Rich" 1 => "T. Zuluaga Toro" 2 => "J. Tanksley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/gut.2010.220061" "Revista" => array:6 [ "tituloSerie" => "Gut" "fecha" => "2010" "volumen" => "59" "paginaInicial" => "1617" "paginaFinal" => "1624" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20926644" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0260" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Polypoid lesions in the stomach and proximal esophagus. Ménétrier's disease of the stomach" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Maffei" 1 => "H. Piessevaux" 2 => "A. Jouret-Mourin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.gastro.2011.02.063" "Revista" => array:5 [ "tituloSerie" => "Gastroenterology" "fecha" => "2011" "volumen" => "140" "paginaInicial" => "32, 369" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21396369" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0265" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endosonographic evalation of giant gastric folds" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Y. Songur" 1 => "T. Okai" 2 => "H. Watanabe" 3 => "Y. Motoo" 4 => "N. Sawabu" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Gastrointest Endosc" "fecha" => "1995" "volumen" => "41" "paginaInicial" => "468" "paginaFinal" => "474" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7615225" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0270" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ganciclovir treatment in Ménétrier disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "V. Hoffer" 1 => "Y. Finkelstein" 2 => "J. Balter" 3 => "M. Feinmesser" 4 => "B. Garty" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Paediatr" "fecha" => "2003" "volumen" => "92" "paginaInicial" => "983" "paginaFinal" => "986" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12948079" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0275" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reversible protein-losing hypertrohic gastropathy: causal relationship with <span class="elsevierStyleItalic">Helicobacter pylori</span> infection, or simple coincidence?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "I. Simon" 1 => "I. Fehér" 2 => "A. Salamon" 3 => "E. Vadász" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1572-0241.2000.01951.x" "Revista" => array:6 [ "tituloSerie" => "Am J Gastroenterol" "fecha" => "2000" "volumen" => "95" "paginaInicial" => "1091" "paginaFinal" => "1092" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10763972" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0280" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Octreotide reduces enteral protein losses in Ménétrier's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Yeaton" 1 => "H.F. Frierson Jr." ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Gastroenterol" "fecha" => "1993" "volumen" => "88" "paginaInicial" => "95" "paginaFinal" => "98" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8420282" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0285" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Successful use of octreotide to treat Ménétrier's disease: a rare cause of abdominal pain, weight loss, edema, and hypoalbuminemia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Rothenberg" 1 => "R. Pai" 2 => "K. Stuart" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10620-009-0754-z" "Revista" => array:6 [ "tituloSerie" => "Dig Dis Sci" "fecha" => "2009" "volumen" => "54" "paginaInicial" => "1403" "paginaFinal" => "1407" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19255847" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0290" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of Ménétrier's disease with a monoclonal antibody against the epidermal growth factor receptor" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Burdick" 1 => "E. Chung" 2 => "G. Tanner" 3 => "M. Sun" 4 => "J. Paciga" 5 => "J. Cheng" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM200012073432305" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2000" "volumen" => "343" "paginaInicial" => "1697" "paginaFinal" => "1701" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11106719" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0295" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy of cetuximab in the treatment of Menetrier's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.H. Fiske" 1 => "J. Tanksley" 2 => "K.T. Nam" 3 => "J.R. Goldenring" 4 => "R.J. Slebos" 5 => "D.C. Liebler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Sci Transl Med" "fecha" => "2009" "volumen" => "1" "paginaInicial" => "8" "paginaFinal" => "18" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0300" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Zollinger–Ellison syndrome. Clinical presentation in 261 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.K. Roy" 1 => "D.J. Venzon" 2 => "H. Shojamanesh" 3 => "A. Abou-Saif" 4 => "P. Peghini" 5 => "J.L. Doppman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Medicine (Baltimore)" "fecha" => "2000" "volumen" => "79" "paginaInicial" => "379" "paginaFinal" => "411" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0305" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Zollinger–Ellison syndrome: a comprehensive review of historical, scientific, and clinical considerations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.C. Ellison" 1 => "J.A. Johnson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1067/j.cpsurg.2008.09.001" "Revista" => array:6 [ "tituloSerie" => "Curr Probl Surg" "fecha" => "2009" "volumen" => "46" "paginaInicial" => "13" "paginaFinal" => "106" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19059523" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0310" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Serum gastrin in Zollinger–Ellison syndrome: I. Prospective study of fasting serum gastrin in 309 patients from the National Institutes of Health and comparison with 2229 cases from the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.J. Berna" 1 => "K.M. Hoffmann" 2 => "J. Serrano" 3 => "F. Gibril" 4 => "R.T. Jensen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Medicine (Baltimore)" "fecha" => "2006" "volumen" => "85" "paginaInicial" => "295" "paginaFinal" => "330" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0315" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgery to cure the Zollinger–Ellison syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.A. Norton" 1 => "D.L. Fraker" 2 => "H.R. Alexander" 3 => "D.J. Venzon" 4 => "J.L. Doppman" 5 => "J. Serrano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199908263410902" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1999" "volumen" => "341" "paginaInicial" => "635" "paginaFinal" => "644" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10460814" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0320" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gastric carcinoids after long-term use of a proton pump inhibitor" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.S. Jianu" 1 => "R. Fossmark" 2 => "T. Viset" 3 => "G. Qvigstad" 4 => "O. Sørdal" 5 => "R. Mårvik" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/apt.12012" "Revista" => array:6 [ "tituloSerie" => "Aliment Pharmacol Ther" "fecha" => "2012" "volumen" => "36" "paginaInicial" => "644" "paginaFinal" => "649" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22861200" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0325" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The prevalence of <span class="elsevierStyleItalic">Helicobacter pylori</span> infection in different countries" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.E. Pounder" 1 => "D. Ng" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Aliment Pharmacol Ther" "fecha" => "1995" "volumen" => "9" "paginaInicial" => "33" "paginaFinal" => "39" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7766741" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0330" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The clinical significance of thickened gastric folds" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Tran" 1 => "P. Hung" 2 => "R. Laucirica" 3 => "R.E. Hilal" 4 => "R.W. Goodgame" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Gastroenterol" "fecha" => "2002" "volumen" => "35" "paginaInicial" => "138" "paginaFinal" => "143" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12172358" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0335" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Helicobacter pylori acute gastritis: histological, endoscopical, clinical, and therapeutic features" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "G.A. Rocha" 1 => "D.M. Queiroz" 2 => "E.N. Mendes" 3 => "A.J. Barbosa" 4 => "G.F. Lima Júnior" 5 => "C.A. Oliveira" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Gastroenterol" "fecha" => "1991" "volumen" => "86" "paginaInicial" => "1592" "paginaFinal" => "1595" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1951235" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0340" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endoscopic aspects of gastric syphilis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Souza" 1 => "T. Guimarães" 2 => "F. Olavo" 3 => "K. Toma" 4 => "C. Eliane" 5 => "E. Ryoka" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2012/646525" "Revista" => array:5 [ "tituloSerie" => "Case Rep Med" "fecha" => "2012" "volumen" => "2012" "paginaInicial" => "646525" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22924047" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0345" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Syphilitic gastritis: an aetiology to consider" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L. Ferreira-González" 1 => "E.P. Rubin" 2 => "J.C. Álvarez-Fernández" 3 => "T. Caínzos-Romero" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eimc.2011.11.001" "Revista" => array:6 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "2012" "volumen" => "30" "paginaInicial" => "105" "paginaFinal" => "107" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22195974" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0350" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gastroduodenal tuberculosis management guidelines" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Y.G. Rao" 1 => "G.K. Pande" 2 => "P. Sahni" 3 => "T.K. Chattopadhyay" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Can J Surg" "fecha" => "2004" "volumen" => "47" "paginaInicial" => "364" "paginaFinal" => "368" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15540690" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0355" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "EUS in patients with large gastric folds at endoscopy and biopsies negative for malignancy: predictors of malignancy and clinical impact" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Ginès" 1 => "M. Pellise" 2 => "G. Fernández" 3 => "M.T. Soria" 4 => "A. Mata" 5 => "A. Membrillo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1572-0241.2005.00349.x" "Revista" => array:6 [ "tituloSerie" => "Am J Gastroenterol" "fecha" => "2006" "volumen" => "101" "paginaInicial" => "64" "paginaFinal" => "69" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16405535" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0360" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gastric MALT lymphoma: old and new insights" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Zullo" 1 => "C. Hassan" 2 => "L. Ridola" 3 => "A. Repici" 4 => "R. Manta" 5 => "A. Andriani" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Gastroenterol" "fecha" => "2014" "volumen" => "27" "paginaInicial" => "27" "paginaFinal" => "33" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24714739" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0365" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effects of Helicobacter pylori eradication on early stage gastric mucosa-associated lymphoid tissue lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Zullo" 1 => "C. Hassan" 2 => "F. Cristofari" 3 => "A. Andriani" 4 => "V. De Francesco" 5 => "E. Ierardi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.cgh.2009.07.017" "Revista" => array:6 [ "tituloSerie" => "Clin Gastroenterol Hepatol" "fecha" => "2010" "volumen" => "8" "paginaInicial" => "105" "paginaFinal" => "110" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19631287" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0370" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eradication therapy in <span class="elsevierStyleItalic">Helicobacter pylori</span>-negative, gastric low-grade mucosa-associated lymphoid tissue lymphoma patients: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Zullo" 1 => "C. Hassan" 2 => "L. Ridola" 3 => "V. De Francesco" 4 => "L. Rossi" 5 => "S. Tomao" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MCG.0b013e318286ff72" "Revista" => array:6 [ "tituloSerie" => "J Clin Gastroenterol" "fecha" => "2013" "volumen" => "47" "paginaInicial" => "824" "paginaFinal" => "827" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23442842" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0375" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "GIST of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Miettinen" 1 => "L.H. Sobin" 2 => "J. Lasota" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "2005" "volumen" => "29" "paginaInicial" => "52" "paginaFinal" => "68" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15613856" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0380" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gastrointestinal stromal tumors: the histology report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.P. Dei Tos" 1 => "L. Laurino" 2 => "I. Bearzi" 3 => "L. Messerini" 4 => "F. Farinati" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1590-8658(11)60586-0" "Revista" => array:7 [ "tituloSerie" => "Dig Liver Dis" "fecha" => "2011" "volumen" => "43" "numero" => "Suppl. 4" "paginaInicial" => "S304" "paginaFinal" => "S309" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21459336" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0385" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endoscopic and histopathological features of gastrointestinal amyloidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Hokama" 1 => "K. Kishimoto" 2 => "M. Nakamoto" 3 => "C. Kobashigawa" 4 => "T. Hirata" 5 => "N. Kinjo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4253/wjge.v3.i8.157" "Revista" => array:6 [ "tituloSerie" => "World J Gastrointest Endosc" "fecha" => "2011" "volumen" => "3" "paginaInicial" => "157" "paginaFinal" => "161" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21954412" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0390" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gastrointestinal manifestations of amyloidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.C. Ebert" 1 => "M. Nagar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1572-0241.2007.01669.x" "Revista" => array:6 [ "tituloSerie" => "Am J Gastroenterol" "fecha" => "2008" "volumen" => "103" "paginaInicial" => "776" "paginaFinal" => "787" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18076735" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0395" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gastrointestinal and hepatic manifestations of sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E.C. Ebert" 1 => "M. Kierson" 2 => "K.D. Hagspiel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1572-0241.2008.02202.x" "Revista" => array:6 [ "tituloSerie" => "Am J Gastroenterol" "fecha" => "2008" "volumen" => "103" "paginaInicial" => "3184" "paginaFinal" => "3192" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18853979" "web" => "Medline" ] ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0400" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathology and differential diagnosis of chronic, noninfectious gastritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.D. Polydorides" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.semdp.2014.02.008" "Revista" => array:6 [ "tituloSerie" => "Semin Diagn Pathol" "fecha" => "2014" "volumen" => "31" "paginaInicial" => "114" "paginaFinal" => "123" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24815937" "web" => "Medline" ] ] ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib0405" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Upper gastrointestinal involvement of Crohn's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.L. Annunziata" 1 => "R. Caviglia" 2 => "L.G. Papparella" 3 => "M. Cicala" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10620-012-2072-0" "Revista" => array:6 [ "tituloSerie" => "Dig Dis Sci" "fecha" => "2012" "volumen" => "57" "paginaInicial" => "1618" "paginaFinal" => "1623" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22350786" "web" => "Medline" ] ] ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib0410" "etiqueta" => "40" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eosinophilic gastroenteritis: an unusual type of gastroenteritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.B. Ingle" 1 => "C.R. Hinge Ingle" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3748/wjg.v19.i31.5061" "Revista" => array:6 [ "tituloSerie" => "World J Gastroenterol" "fecha" => "2013" "volumen" => "19" "paginaInicial" => "5061" "paginaFinal" => "5066" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23964139" "web" => "Medline" ] ] ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib0415" "etiqueta" => "41" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eosinophilic gastroenteritis associated with giant folds" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Ishido" 1 => "S. Tanabe" 2 => "K. Higuchi" 3 => "T. Sasaki" 4 => "C. Katada" 5 => "M. Azuma" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1443-1661.2010.01012.x" "Revista" => array:6 [ "tituloSerie" => "Dig Endosc" "fecha" => "2010" "volumen" => "22" "paginaInicial" => "312" "paginaFinal" => "315" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21175485" "web" => "Medline" ] ] ] ] ] ] ] ] 41 => array:3 [ "identificador" => "bib0420" "etiqueta" => "42" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gastric polyps: a review of clinical, endoscopic, and management decisions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.S. Islam" 1 => "N.C. Patel" 2 => "D. Lam" 3 => "C.C. Nguyen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Gastroenterol Hepatol" "fecha" => "2013" "volumen" => "9" "paginaInicial" => "640" "paginaFinal" => "651" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000014400000010/v1_201601310051/S2387020615002831/v1_201601310051/en/main.assets" "Apartado" => array:4 [ "identificador" => "44144" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Diagnosis and treatment" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000014400000010/v1_201601310051/S2387020615002831/v1_201601310051/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020615002831?idApp=UINPBA00004N" ]
Journal Information
Vol. 144. Issue 10.
Pages 470-474 (May 2015)
Share
Download PDF
More article options
Vol. 144. Issue 10.
Pages 470-474 (May 2015)
Diagnosis and treatment
Large gastric folds: Differential diagnosis
Pliegues gástricos engrosados: diagnóstico diferencial
Visits
68
Ana García García de Paredes
, Javier Martínez González, Laura Crespo Pérez
Corresponding author
Servicio de Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
This item has received
Article information
These are the options to access the full texts of the publication Medicina Clínica (English Edition)
Subscriber
Subscribe
Purchase
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail