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Benign Lesions at Gastroenterostomy Site: Stomal ulcer and stomal polyp M. Enjoji 1 , S. Koga 1 1Second Department of Pathology, Faculty of Medicine, Kyushu University pp.893-902
Published Date 1977/7/25
DOI https://doi.org/10.11477/mf.1403112616
  • Abstract
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 The present paper deals with two representative benign lesions in the gastroenteric stoma, i.e. stomal ulcer and stomal polyp. Specimens of the second resection from 46 patients who had previously undergone gastric operation for various diseases of the stomach or duodenum were collected from several institutes and hospitals for the pathologic study.

 Out of 21 patients with the stomal peptic ulcer, 16 had been operated on because of duodenal ulcer. The stomal ulcers were located almost invariably in the jejunum within the scope of gastroenteric stoma, and never developed in the afferent or efferent loops. The so-called suture line ulcer occurred in one patient. The antrum partiall remained in approximately 30 per cent of the patients with stomal ulcer who had undergone a partial gastrectomy. Pseudopyloric-gland metaplasia of the fundic glands developed in the mucosa near the stoma in almost every case. The glands should be distinguished from the original pyloric glands in the antrum.

 As to the polypoid change at the gastroenteric stoma, the lesion,“gastritis cystica polyposa”, described by Littler and Gleibermann represents one extreme end of morphologic spectrums. We have recently shown that essentially the same lesions of varying lesser degrees develop in the gastric mucosa at the stoma on many occasions (Koga et al., 1976). Another review of the specimens convinced us that these lesions were peculiar mucosal changes of a reactive nature probably caused by the duodenal juice flowing backward. The changes consisted basically of hyperplasia of young foveolar epithelium and pseudopyloric-gland metaplasia with cystic dilatation of the glands, occurring in the mucosal folds to produce polypoid protrusions. We propose to call this spectrum of lesions “stomal polypoid hypertrophic gastritis”.


Copyright © 1977, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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