Pathological Aspect of Acute Gastric Lesion and Chronic Gastric Ulcer N. Nakamura 1 , T. Sakurai 1 , T. Nagasu 1 , S. Tamura 1 , F. Nagao 1 1The Second Department of Surgery, Jikei University School of Medicine pp.1473-1479
Published Date 1979/11/25
DOI https://doi.org/10.11477/mf.1403107818
  • Abstract
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 A distinctive feature of acute gastric lesion or acute gastric ulcer remains obscure, and their clinical and morphologic characteristics remain to be defined.

 For over the last two years, we have studied characteristic features of acute gastric ulcer by investigating six cases of histologically proven acute gastric ulcer and comparing their histological findings to chronic gastric ulcer.

 The all six cases had severe hematoemesis and melena which couldn’t be controlled by convensional management. Therefore, all of them underwent gastrectomy and the resected specimens were used for investigation.

 Analysing these cases, we found that all acute gastric ulcers, in contrast to chronic ones, were shallow enough to be classified as and exposed vessels were always noted in their ulcer bases.

 On the other hand, their ulcer size depended on their location, namely ulcers in the body of the stomach were small and ulcers adjacent to acid secreting mucosa were large. It was also found that occurrence of ulcer was more predominant in the area of fundic glands.

 In acute gastric ulcer, mucosal atrophy was frequently recognized in the area of fundic glands where erosion was often noted.

 On the other hand erosions tend to develop at the body of the stomach in acute gastric ulcer and their histological evaluation disclosed hemorrhagic necrosis.

 However, erosions associated with chronic gastric ulcer were histolytic type necrosis and much less in quantity.

 We feel that the possible mechanism of development of acute gastric ulcer could be due to marked mucosal circulatory disturbance by unknown causes, then it produces erosion and peptic ulcer in the atrophic mucosa. Finally, conjested submucosal vessels protrude into their bases and produce massive bleeding.

Copyright © 1979, Igaku-Shoin Ltd. All rights reserved.


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