大彎側の陥凹性病変の2例

TWO CASES OF DEPRESSION-LIKE CHANGE ON THE GREATER CURVATURE

Ⅰ．症例

1）症例1：胃体上部大彎側の多発性潰瘍

患者：46歳　女

昭和43年8月17日初診，同年9月6日手術施行．

一般検査所見：赤沈1時間値17，2時間値44．中等度の貧血（赤血球数333万．血色素量68％）を認め，検尿・肝機能検査などに異常なく，ワ氏反応陰性．

　Case No. 1 Multicentric ulcer on the greater curvature of the upper gastric corpus.

　Patient: female, 46 years of age.

　The gastric juice showed hypoacidity. X-ray examination of barium-filled stomach, standing position, revealed marginal irregularity on the greater curvature of the upper gastric corpus. The double contrast study was successful in bringing out the convergence of mucous folds with two foci. By the use of gastroscope an uneven ulcer was detected on the protuberance of mucosal folds, as well as cicatrices of an ulcer. The possibility of malignant ulcer was not to be discarded entirely, and so the subtotal removal of the stomach was carried out.

　The examination of the excised stomach revealed a benign linear ulcer on the greater curvature of the gastric corpus, and the cicatrices of an ulcer there.

　Case N0. 2 Stomach cancer on the greater curvature opposite the gastric angle.

　Patient: female, 50 years of age.

　X-ray examination of barium-filled stomach, standing position, brought out irregular hardening on one section of the greater 'curvature 'opposite the incisura. The double contrast study, supine position, revealed the convergence of mucosal folds toward the irregular-shaped depression. It was accompanied with their sudden interruption, petering out and fusion.

　Endoscope examination revealed an ulcer of indistinctive margin, with uneven floor surface. The outward appearance of the convergence of plicae was convincing of stomach cancer, and the removal of the stomach was carried out.

　This was a case of progressive cancer resembling early gastric cancer (Type Ⅱc plus Ⅲ), the size of which was 5×15 mm and its position was 7cm oral to the pyrolic ring.

　Histologically it was adenocarcinoma tubulare mucocellulare, with p.m. degree of depth.