胃に奇異な集簇性“mucosalbridge”および多発性小潰瘍を呈した1症例

Peculiar Mucosal Bridge Formed in the Stomach, Report of a Case

　最近消化管に特異なmucosal bridgeを形成する症例のあることが注目され，とくに大腸では既に本邦にて数例の報告がみられ^1)～4)，その原因として炎症性ポリポージスとの関連が論じられている．また食道でも最近1症例が報告された⁵⁾．しかし胃においては，その診断技術の目覚ましい進歩と，広範な検診の症例があるにもかかわらず，いまだこのような症例の報告をみない．

　最近われわれは，胃の，主として胃体部のほぼ全域にわたって，奇異な形をしたmucosal bridgeが集簇をなして形成され，また多数の小潰瘍を併発した1症例を経験したので報告する．

　The patient was a 40 year-old man. Since the end of 1975, he had malaise in the upper abdominal region and, in July 1976, he complained of the sensation of distended abdomen and vomiting after meals, and his body weight was reduced.

　The fluoroscopic examination of the stomach revealed deformity of body in barium-filled picture in the upright position, and broad folds and many concavities of various sizes in double contrast picture. The endoscopic examination also revealed diverticular concavities of various sizes on the mucous membrane of the body.

　The resected stomach showed a large mucosal bridge connecting the anterior and posterior walls in the upper part of the antrum, punched-out-like concavities in the lower part of body, and communication between adjacent concavities in the base. In the middle portion of gastric body, the folds were mutually fused, appearing like the cerebral gyri.

　Histologically, the bridge and the fused folds were covered with mucous membrane. The submucous tissue showed fibrosis of various degrees. The lamina muscularis mucosae partly disappeared and fragmented or thickened and laminated. In some localities, the upper portion of the lamina muscularis propriae was fragmented and the muscular tissue was enfolded in the fibrotic tissue. In the tunnel in the portion of fused foldings, multiple small ulcers of to IV were observed. The cause was considered to be traumatic since the patient seemed to have accidentally swallowed glass recently.