明らかな瘢痕を残して治癒した急性胃潰瘍の1例

A Case of Acute Gastric Ulcer with Apparent Ulcer-scar Healing

　近年，急性潰瘍に関する臨床的および病理学的検討がなされると同時に，特異的な内視鏡像から多くの急性潰瘍が報告されている．著者らは内視鏡的に比較的広い陥凹した瘢痕面と，周辺粘膜の結節を残して治癒し，その後2年間再発をみなかった急性胃病変の1例を経験したので，その内視鏡像の推移を中心に報告する．

　We followed acute gastric ulcer endoscopically for two years and observed apparent ulcer-scar healing in 22 year-old female.

　We confirm that there were no recurrence of the ulcer and no evidence of passing into a chronic state during the study, and detailed endoscopic feature along with ulcer healing were reported.

　A case was 22 year-old female who complained of epigastric pain, nausea and vomiting without any apparent cause. Initial endoscopic examination disclosed edematous mucosa with nodular swelling and irregular erosions with marked adjacent hyperemic mucosa from angulus to amtrum. There were also a shallow ulcer with white exsudate at the angulus.

　Three Weeks later, a depressed lesion associated with marked converging folds, which center was at the lesser curvature of the angulus, was noted.

　There were also scattered ulcers with white exsudate around the above lesion. The previous erosions in the antrum were completely healed without leaving scars.

　Four months later, endoscopico bservation disclosed converging folds at the anterior and posterior wall of the angulus, and there were several hyperemic mucosal nodules at the tip of converging folds. No more white exsudate was seen and the depressed lesion became brownish color. Therefore, it was felt that the previous acute gastric ulcer end up with scar healing and left converging folds.

　Endoscopy was repeated one year and six months later as well as two years later but they merely showed converging folds and nodular mucosal change at the scar lesion, and no evidence of recurrent ulcer nor mucosal abnormalities in the antrum were noted.