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A Case of Giant Rugae of the Stomach with Protein-loss (Ménétrier's Disease) S. Nakazawa 1 , Y. Naito 1 , Y. Tsukamoto 1 , M. Aichi 1 1The 2 nd Department of Internal Medicine, Nagoya University School of Medicine pp.1055-1060
Published Date 1978/8/25
DOI https://doi.org/10.11477/mf.1403107401
  • Abstract
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 A 35-year-old man, who complained of bilateral pretibial edema, was admitted to our hospital. He had no remarkable family history nor past history. The laboratory data showed a marked hypoproteinemia (serum protein value was 4.4 g/dl), and the protein-loss into the alimentary tract was suggested by a protein-losing test utilizing RISA. X-ray photographs of the stomach showed extensive huge and tortuous folds at the greater curvature of the body and a large mass lesion measuring about 3 by 5 cm on the posterior wall of the angulus. The surface of both lesions was roughly granular. The distensibility of the gastric mucosa was well preserved.

 A gastrofiberscopic examination showed the same lesions as revealed by X-ray examination. It was concluded that the giant rugae at the greater curvature of the body were based on hypertrophic gastritis of the fundic mucosa, but strictly speaking, the mass lesion on the posterior wall of the angulus was not diagnosed correctly before surgery. There were three kinds of conceivable lesions about it: 1. It could be a part of a diffuse type of hypertrophic gastritis. 2. It could be a localized type of hypertrophic gastritis apart from a diffuse type. 3. A carcinoma might co-exist with hypertrophic gastritis in spite of the negative findings of the gastric biopsy under the endoscopic examination.

 The subtotal gastrectomy was performed because no improvement of the serum protein value was gained under the medical therapy, and the diagnosis of a diffuse type of primary hypertrophic gastritis was established. The lesion difficult to diagnose before surgery was only one part of it, and there was no evidence of malignancy. After surgery, he recovered his health, and about three weeks later the serum protein level was improved with its value of 6.0 g/dl.


Copyright © 1978, 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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