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Diagnosis of Duodenal Ulcer and the Problems at Issue: On the criteria of ulcer healing based on x-ray findings K. Nomoto 1 , M. Nishizawa 2 11st Dept. of Internal, Medicine Faculty of Medicine, Chiba University 2Chiba Cancer Center Hospital pp.1601-1607
Published Date 1973/12/25
DOI https://doi.org/10.11477/mf.1403108410
  • Abstract
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 These have been as yet no definite criteria established from the viewpoint of both x-ray and endoscopy regarding the determination of healing in duodenal ulcer. In this paper are compared x-ray findings of duodenal ulcer with excised specimens in order to determine how far x-ray findings can possibly be connected with the determination of ulcer healing.

 The subjects of the present study are 40 cases with 55 ulcer lesions histologically and radiographically thoroughly examined, selected out of 143 cases of duodenal ulcer encountered at the First Department of Internal Medicine, Chiba University College of Medicine, during the 8 years 1965~1972.

 The degree of vertical involvement of the duodenal wall as well as that of repairing process was divided into four stages according to Prof. Murakami's classification. X-ray findings were also divided into four groups: niche, barium fleck, dotted shadow and fine mucosal convergency. All the findings were based on those obtained by compression in upright posture.

 Results

 1. Comparison of the degree of ulcer repair with x-ray findings showed that niche was recognized in the area where ulcer repair was either in the degree 1 or 2. Barium fleck was seen in the area of 2 or 3 degree, and fine mucosal convergency was seen in the area where the degree of ulcer repair was 3.

 2. If ulcer repair in or over the degree 2 be considered healed stage, x-ray findings showing no more than barium fleck can be regarded as a definite sign of healed ulcer. On the other hand, if ulcer repair in or over the degree 3 be considered as showing healed stage of ulcer, corresponding x-ray findings are no more than dotted shadows or fine mucosal convergency as signs of ulcer healing. Consequently, these findings can be construed as a picture of ulcer scar.

 The cases presented here are illustrated with x-ray pictures showing barium fleck, dotted shadow and fine mucosal convergency.


Copyright © 1973, 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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