経過を観察しえた自動車用バッテリー液誤飲による腐しょく性胃炎（胃潰瘍）の1例

Corrosive Gastritis and Ulcer Due to Drinking by Mistake of Battery Fluid for Automobile, Report of a Case

　腐しょく性胃炎の報告は決して少なくないが，形態学的に詳細に経過を観察した報告は極めてまれである．われわれはアルコール痛飲後自動車用バッテリー液を誤飲した患者について，保存療法にて治癒せしめ胃X線および内視鏡にて追跡しえたので報告する．

症　例

患　者：71歳，男性．

主　訴：心窩部痛を伴う吐lf[L．

家族歴：特記すべきものなし．

既往歴：69歳，腰椎骨折．

現病歴：1982年5月19目，焼酎を痛飲後，午後8時30分ごろ，焼酎と誤って自動車用バッテリー液を約200ml飲み，その直後より赤褐色の吐物を約500ml嘔吐し，また激しい心窩部痛を訴えたため，同日午後10時25分，本院へ緊急入院した．

　On May 19, 1982, a 71 year-old man drank by mistake about 200 ml of battery fluid for automobile after he had taken a swig at shochu (spirits). Shortly thereafter he complained of epigastric pain and he threw up about 500 ml of red brown mass. He was admitted to the hospital at 10:25 p.m. of the same night. At the time of admission the epigastrium was tender and the feces were positive for occult blood (+++). Examination of the blood showed RBC 475×10⁴, WBC 9,590 with neutrophil 92%, acidophil 0%, lymphocyte 6% and monocyte 2%. Hb was 16.1g/dl, Ht 48%, and blood gastrin was 78pg/ml. The gastric juice (tetragastrin method) was hypoacid. Immediately after admission gastric lavage was carried out. The pain in the epigastrium disappeared on the third day. X-ray examination on June 8, 1982, showed in barium-filled picture striking shortening of the pyloric antrum, symmetrical stricture and irregular contours of the walls. In double contrast picture multiple shallow ulcers of irregular shape were seen along with a dozen of rather thick mucoral folds converging toward them. However, the tips of the folds were of benign appearance, showing no disruption, moth-eaten picture, club-like swelling or fusion. Both the greater and lesser curvatures of the pyloric antrum were constricted, showing formation of a pseudodiverticle. Endoscopic examination on June 4 of the same year showed diffuse reddened mucosa. Especially the pyloric antrum was remarkably constricted. On the oral side were seen circumferential ulcers of irregular shape with relatively clean white coat. The converging mucosal folds toward the ulcers were edematous and swollen. Epitheliae of the gastric pits, showing intestinal metaplasia and consisting of long columnar cells, were arranged irregularly. In parts was seen invagination but there was no malignant picture. Strong infiltration of neutrophil cells was seen in the lamina propria mucosae. X-ray examination four weeks later and endoscopy about three weeks later did not show any ulcers in the pyloric antrum, leaving only slight mucosal convergency and formation of a pseudodiverticle. In the past reports of acute corrosive gastritis due to acid almost all the patients underwent operation. This patient was successfully treated by conservative management only and was followed up meticulously by x-ray and endoscopy of the stomach, and we consider it worth reporting here.