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Vascular Structure of Gastric Ulcer, with Special Reference to the Role in Healing and Recurrence K. Maruyama 1 , M. Ohotzuki 2 , Y. Hiki 3 , T. Moriya 4 , Y. Ishii 5 1Dept. of Surgery, National Cancer Center 2Ohotzuki Hospital 3Dept. of Surgery, Kitasato Uuiv 4Fujita-Gakuen Univ. Sclcool of Med 5Dept. of Surgery, Keio Univ pp.523-531
Published Date 1973/4/25
DOI https://doi.org/10.11477/mf.1403108462
  • Abstract
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 Our improved microangiographic approach has been performed in various types of peptic ulcer of the stomach to clarify its intractability and recurring tendency.

 On the microangiogram of chronic ulcer, there are three zones, i.e., avascular, brush vessel and radiating vessel zone; histologically they represent zone of exudation with necrosis, granulation and scar, respectively.

 From the standpoint of these findings, ulcers can beclassified to five types: active, resting, epithelized, recurrent and pair types. It is of interest to speculate that in course of time ulcer alters from the active to piar type.

 There is some difference between the oral and anal margins of the ulcer on the microangiogram. This seems to show that the oral margin contracts stronger the anal margin.

 In ulcer deeper than the proper muscular layer, abundant submucosal vascular network is destroyed, and there remains only fine radiating vessel (scar vessel). It can readily assumed that healing of deep ulcer is difficult. If it should heal, there appear weak points of blood supply, for the regenerated epithelium is supplied only by the poor radiating vessel. Moreover, the adjacent tissue cannot receive enough blood flow. This fact is compatible with recurrence of ulcer in the adjacent area.

 Our study reveals that intractable and recurred ulcers have deeper and wider radiating vessel, and in some cases there are multiple foci of radiating vessel, which is thought the result of healing and recurrens of ulcer. This microangiographic pattern is often recognized in linear, kissing, tadpole-shaped or irregular-shaped ulcers with surrounding wide scar tissue.


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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