血管構築の立場からみた消化管病変

Morphological Analysis of Gastrointestinal Disease on the Basis of Normal Organ Vasculature

　消化管は生体の中で最も可動性に富む長い管腔臓器であり，解剖学的には食道から直腸にいたる各部位に分けられている．それぞれの部に固有の機能があり，それゆえに機能変調の場合には，部位によってそれぞれに特徴ある病態を呈してくる．病気は消化管に限らず臓器の機能変調の現れであると同時に，形態変化の現れでもあり，それは正常の臓器構築の改変をも意味している．病態の追求はこれらの機能と構造との関連解明に始まり，またこのことは最終的な目標でもある．

　消化管の機能を規制する構造要素の1つに血管構築がある．血管構築の立揚から臓器特性を明確にしつつ消化管病変の解明を意図せんとした．こういった観点から消化管病変を論じてみた．

　From the standpoint of vasculature are discussed functions and pathogenesis in the digestive tract. Function of the gastric mucosa is reflected by one of the chief functions of the stomach. One structural factor that controls the gastric mucosa in relation to the gastric function is vasculature. It is closely related with the vascular networks distributed in the submucosal layer. Vascular distribution was found to be peculiar to each layer of the muscular coat. Blood vessels within the oblique muscular layer were wider and more coarsely distribtued as compared with those in the circular layer, which in its turn showed denser distribution of blood vessels, and hence of narrower caliber. This means hydrodynamically that the area of the circular layer corresponding to the lesser curvature side shows lesser blood flow as compared with the corpus, which is the area of oblique layer. This fact seems to show that peptic ulcer on the lesser curvature side is more likely to recur and enduring inflammation is more apt to take place.

　Ulcer of the small intestine is caused by a group of diseases of unknown etiology which would develop as a predilection site in the peripheral area of circulation as seen from the vasculature

　It is important for their prognosis and treatment to decide the pathogenesis of acute ischemic lesions of the small intestine depending on the differentiation whether they be of venous or arterial origin. We believe the discrimination possible.

　Advanced cancer of the stomach showed in the angiography of minute blood vessels obvious hypervascularity. In early cancer it was inconspicuous. Blood vessels proper to the stomach showed prominent encasement in early cancer.

　We have also referred to a fact that submucosal tumors have each peculiar tumor vasculature and to the existence of tumor vessels of venous nature.