胃潰瘍瘢痕の経過―特に，X線からみた再発と短い線状瘢痕のなりたちについて

The Course of Gastric Ulcer Scar: with special reference to recurrence of gastric ulcer roentgenologically ascertained and to formation of short linear scar

　胃潰瘍瘢痕の経過観察の目的¹⁾²⁾⁵⁾は，瘢痕癌の問題，再発の実体，線状潰瘍のなりたちなどをさぐろうということにある．

　再発については，本誌（1966）²⁾に，再発はないと発表したことがある．筆者らは，個々の瘢痕の経過をX線的に追求するという立場から，再発を潰瘍が再び潰瘍化してくること，と定義している．そして，瘢痕の経過をみていると，ちがった部位に潰瘍が発生してくることはあっても，瘢痕そのものが潰瘍化した例はなかったのである．

　Recurrence of gastric ulcer and origin of short linear scar have been investigated based on the results of x-ray follow-up in the course of gastric ulcer scar.

1. On recurrence

The objects of this study were 112 cases, 128 ulcer scars, periodically checked up from one year to eight years up to July 1970.

　1) Formation of ulcer numbered 23 in 17 cases.

　2) Topographical relation of these 23 ulcers to ulcer scars being followed up showed that nine ulcers were more than one cm distant from ulcer scars, while 13 ulcers were adjacent to them. In one ulcer it was impossible to determine its topographical relation to ulcer scar.

　3) No recurrence (re-ulceration of ulcer scar) was recognized except the one mentioned above.

2. On the formation of short linear scar

Origin of short linear scar has been studied based on the following results:

　1) The pattern of ulcer diminution in 52 cases, 58 ulcer scars, is basically concentric.

　2) No recurrence of ulcer from ulcer scar was observed. When an ulcer originates in an area adjacent to an existing scar, it takes a tadpole shape. The scar and ulcer has become contiguous then. Finally it forms a linear scar.

　3) Histology of the resected stomachs (89 cases, 120 ulcers) shows that short linear ulcer under 19 mm in length was due to linear scar and tadpole-shaped ulcer.

　For the formation of short linear scar, the result of the present study affords an explanation that recurrence of ulcers in neighboring areas leads to it.