When the Z-line is not completely normal
Depending on the patient’s degree of sedation and the examiner’s level of experience, carrying out a precise examination of the Z-line may not be very easy. However, it is worth taking biopsies from minimal focal changes, areas of reddening, bumps and irregularities, even when they have an “inflammatory” appearance. Contact vulnerability when the device is passing should also attract attention.
NB: nearly all of the following cases were examined and biopsied by colleagues in private practice. The challenge lies in filtering out suspect findings from among the mass of inflammatory changes that are caused by reflux.