Characteristics and Prognosis of Intractable Gastric Ulcer Determined by Endoscopic Observations of Ulcer Scars Nobuhiro Sakaki 1 , Kumiko Momma 1 , Yoshiya Yamada 1 , Yasumasa Tadokoro 1 , Tsuyoshi Tajima 2 1Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital 2Department of Endoscopy, Tokyo Metropolitan Komagome Hospital Keyword: 内視鏡診断 , 潰瘍瘢痕 , 拡大内視鏡 , 難治性潰瘍 , 治癒判定 pp.1403-1411
Published Date 1992/12/25
DOI https://doi.org/10.11477/mf.1403110193
  • Abstract
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 We have reported that the findings of gastric ulcer scarring by magnification endoscopy can help estimate the likelihood of recurrence of peptic ulcer. Classification of peptic ulcer based on the pattern of regenerative mucosa by ordinary endoscopic examination is as follows: Sa (depression remains in the center),Sb (coarse regenerative mucosal pattern extended to the center),Sc (fine mucosal pattern similar to that in the surrounding tissue).

 In this study,61 patients with gastric ulcer were followed up prospectively for 2 years. They were divided into tractable and intractable ulcer groups according to the absence or presence of white coating on the ulcer after 8 weeks of treatment. In 33 tractable ulcer cases,67% of the cases had Sc scar formation and the recurrence rate was 18%. On the other hand, in 28 intractable ones, the scar remained in Sa stage and the recurrence rate was higher (71%). Seventy one percent of intractable ulcer cases, compared with 18% of tractable ones, had a scarring zone which was a well demarcated area with coarse granular regenerative mucosa, specific to Ul-Ⅳ ulcers. These results suggest that intractability and rate of recurrence may be related to the depth of tissue involvement by scar.

Copyright © 1992, Igaku-Shoin Ltd. All rights reserved.


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