急性びらん性胃炎の経過中に潰瘍の発生および再発がみられた症例

A Case of Acute Gastric Mucosal Lesion Developing into Chronic Gastric Ulcer

　急性びらん性胃炎の経過中に潰瘍の発生をみ，しかも潰瘍の再発がみられた症例を呈示する．

症例

　患　者：R. H.　45歳　♂　会社員

　主　訴：心窩部痛

　現病歴：2週間前より上腹部の不快感と空腹時心窩部痛および背部痛を訴える．特に夜間に強く疼痛を訴える．その他，嘔気，嘔吐，胸やけなどはみられない．特に誘因となるものもみられない．胃X線，胃内視鏡検査を受け胃潰瘍と診断され，治療の目的で入院する．

　The patient, a 45-year-old male, complained of epigastralgia. Both pain in the epigastrium in time of hunger and back pain started two weeks before his first examination. Those pains were acute specially at night.

　His past history reveals that he was diagnosed as hemorrhagic erosive gastritis five years and ten months ago.

　His gastric juice test shows normal acid value.

　The following statement is his clinical course consisting mainly of endoscopic findings beginning with his first endoscopic examination taken five years and ten months ago.

　1) first examination showed that there were multiple erosions in both antrum and corpus.

　2) His second examination seventeen months later showed the same features as his first one.

　3) When he was admitted to our hospital nine months ago, ulcer was found in the converging folds of the mucosa which run in the lesser curvature of the angle through endoscopic research.

　4) Endoscopic findings one month after his admission, that is, eight months before the final endoscopic findings showed that ulcer was healing but multiple erosions were spreading from antrum to corpus. Furthermore, one month later, ulcer was noticed as an ulcer scar.

　5) The last endoscopic feature which was carried out seven months after he left the hospital showed that there was recurrent ulcer near the anterior wall of the ulcer scar in the angle noticed in 4).

The above case is observed to show the course of development from hemorrhagic erosive gastritis to chronic gastric ulcer, further to recurrent ulcer.