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Endoscopic Differential Diagnosis of Giant Folds K. Hayakawa 1 , K. Takeuchi 1 , N. Yamada 1 , S. Fukuchi 1 , S. Nishikage 2 1Department of Gastroenterology, Toranomon Hospital 2Department of Patlzoiugy, Toranomon Hospital pp.509-517
Published Date 1980/5/25
DOI https://doi.org/10.11477/mf.1403106826
  • Abstract
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 As diseases which cause giant folds in the stomach, Menetriefs clisease and other benign types of giant folds as well as malignant ones such as B0rrrnann's type 4 gastric cancer and malignant lymphoma can be mentioned ancl also certain types of submucosal tumots, extragastric mass and gastric varices may be occasionally confused with some types of giant folds in endoscopic diagnostic differentiation. We made a survey cf cases having giant folds which were exarnined in this hospital in the last 15 years and classified them into benign cases of giant folds and others, and described what the critical points there were for endoscopic differentiation of the disease.

 Of 19 cases classified as benign giant folds, 2 consiclered to be Menetrier's disease are introduced here for discussion. Some of the endoscopic characteristics of benign giant folds are, (1) The distensibility of the gastric wall is excellent. (2) They occur more centered in the part of the greater curvature of the corpus of the stomach. (3) On the surface, they usually show looks of regular convexo-concave pattern like the gastric area. (4) Often mucus secretion is enhanced. (5) No erosion or ulceration is seen. (6) Often, severe atrophy of mucosal membranes in the pyloric region is seen.

 Of the 177 cases of Borrmann's type 4 gastric cancer, 114 cases (64%) had giant folds, most of which had some degree of erosion or ulceration combined, while only 17 cases did not have either erosion or ulceration (10%). Differentiation of such cases from benign giant folds is a problem, but by observing various endoscopic characteristics, it can be done without much confusion. Of the 20 cases of malignant lymphoma of the stomach,5 were found to have giant fold (5%), all combined with either polypoid lesion or ulceration. We have also described other several diseases of giant folds as critical points for differential diagnosis.


Copyright © 1980, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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