急性胃潰瘍の臨床―成因を中心として

Clinical Aspects of Acute Gastric Ulcers Their occurrence mechanism

　臨床上問題となる急性胃潰瘍として，①ストレスによるもの，②各種薬剤によるもの，③胃の血管性変化に基づくもの，の3つをとりあげ，その成因を中心に考えてみたい．とくに今日その老え方においていささか混乱しているストレス潰瘍に重点をおいて述べることにする．

　Acute gastric ulcers encountered in our clinic are classified into three groups:

　1. those induced by stress;

　2. those due to drug-induced mucosal changes;

　3. those due to vascular circulatory disturbances.

　Both gastric ulcers and hemorrhagic erosions are included in the first two groups. We report incidence of stress ulcers caused by mental stress, head trauma, and brain surgery. The report includes our observations and evaluations of clinically experienced acute, drug-induced gastric lesions. In addition, we present four cases of giant gastric ulcers possibly due to vascular circulatory disturbance, and we suggest that their mechanism of occurrence resembles that which initiates mesentric arterial occlusion.