小児の胃潰瘍と老人の胃潰瘍

Gastric Ulcers in the Field of Pediatrics and the Aged

　小児と老人の疾患は，一般にそれが示す病態像，さらに具体的にいえば，症状，経過，治療に対する反応，予後などにおいて成人と趣を異にする場合が少なくない．いいかえれば同じ疾患でも特異性をもつといってよい．

　したがって診療の実際において，小児は小児なりに，また老人は老人なりに考慮すべき種々の問題点がある．これは胃潰瘍についてもまたいえることである．

　It has been noted that between adults and children and aged, the manifestations of gastric ulcers differ considerably. Gastric ulcers in children show characteristic differences in symptoms, the clinical coures, response to treatment and in its prognosis.

　Based on our experience over a period of 20 years and our clinical cases a discussion was made in the present paper.

　As a recent trend the number of gastric ulcer cases in the field of pediatrics are increasing. This may be attributed to the improvement in diagnostic technics and especially to the advent of clinical application of fiber scopes for children, on the other hand, the detrimental influence of mental stress in children can not be overlooked. While gastric ulcers are not infrequently seen in patients under 10 years of age, there is a prominent increase from around the age of 1 years. And while in general gastric ulcers in the field of pediatrics readily respond to treatment and recovery is readily obtained, it must be remembered that there are cases in which hemorrhage and perforation are seen.

　Recently there is also a distinct trend of increase of gastric ulcers in the aged. Especially it is noted that an increase in the first onset of the disease after 60 years of age is seen. In the aged the site of the gastric ulcer making its appearence shows a high frequency in the upper portion of the stomach and at the same time the frequency of hemorrhage is high.

　It must also be remembered that in gastric ulcers of the aged in various respects arteriosclerotic changes are seen in the entire body or locally (stomach).

　It must also be considered that in the aged characteristic mental stress of the aged would be involved. The depressive state frequently seen in the aged and recurence should also be remembered.