胃潰瘍の瘢痕区域narbiger Bezirkとその臨床的意義について

Scar Zone of Gastric Ulcer and its Clinical Significance

　胃粘膜の変化を，潰瘍の背景として，またX線診断の立場から考察することが与えられたテーマである．従来，胃潰瘍の背景として論じられてきた胃粘膜の変化には，各種のびらん，各種の胃炎あるいは粘膜萎縮などの問題があるが，私たちはこれまで胃潰瘍の背景という視点からはほとんど言及されたことのない胃粘膜の所見として，潰瘍瘢痕を採りあげて考察することにする．

　潰瘍瘢痕は潰瘍治癒の結果であって，それを潰瘍の背景というのは奇矯にきこえるが，潰瘍病変の経過を観察しているうちに，私たちは潰瘍の結果である瘢痕が，かえって潰瘍の推移，予後を左右する要因の1つであり，またその観察によって潰瘍の性状についての多くの情報が得られると考えるようになった．この問題については既に2，3の報告を行なっているが，それらを含めてやや総論的に，潰瘍瘢痕を胃潰瘍の背景という視点から検討してみようということである．

　Since gastric ulcer scar represents the outcome of ulceration and it is considered to exert various influences on the course and prognosis of gastric ulcer, we have studied it from the viewpoint of ulcer background as well as from that of roentgenologic diagnosis.

　The shape of ulcer scar can be described according to the extent of rupture of the lamina muscularis mucosae. Moreover, the shape and size of a given ulcer scar can be determined both macroscopically and radiographically by the signes such as cessation of the mucosal folds, mucosal depression and abnormal areae gastricae that would come out on mucosal surface corresponding in extent to ulcer scar. We have named this extent as scar zone.

　As scar zone would assume various characteristic shapes and sizes dependings on how it has been formed, we have divided it into three types: round scar, linear scar and broad scar zones.

　Types of scar zone are related with the healing course of gastric ulcer, and by studying them it is possible to determine whether or not a given ulcer is likely to heal easily. They have also a bearing on the mechanism of ulcer recurrence, so that their determination likewise enables us to judge whether or not recurrence of ulcer may readily take place.