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Discrepancies and pitfalls in diagnosis and therapy of esophageal columnar metaplasia/Barrett's esophagus: A personal view

The diagnosis of BE is essentially an endoscopic diagnosis. In order to diagnose BE accurately, it is important to adequately identify and localize the esophagogastric junction (EGJ). There are three anatomic landmarks that help in the identification of the EGJ: (i) the proximal end of the gastric folds in the cardia; (ii) a slight narrowing at the level of the internal sphincter, the so-called esophageal pinch; and (iii) the distal end of the palisade vasculature in the distal esophagus (Fig. 3). In a normal situation the EGJ and