急性胃炎の臨床的考察

A Clinical Study of Acute Gastritis

　急性胃炎とは，急激に起る上腹部の疼痛，嘔吐，食思不振等を主訴とし，比較的短期日のうちに症状軽快する疾患であり，臨床上必ずしも稀な疾患ではないように考えられる．にもかかわらず，現在まで急性胃炎についてのまとまった報告は少ないようであり，いまだに胃癌症とまちがえられて手術を受けたり，胆石症や潰瘍穿孔とまちがえられて急患手術を受けたりすることも少なくないような状態である．

　しかし，最近では胃のレ線診断，内視鏡検査，組織生検など，診断技術が著しく進歩し，これらの検査方法を用いれば，急性胃炎を新鮮な状態で，かなり正確にとらえることができるようになってきた．

　This report is based on an analysis of fifty-two cases of acute gastritis. Examinations were conducted over a period of three years 1969～1972. Gastritis was confirmed by means of x-ray and endoscopy.

　The present cases were selected from those patients who visited my hospital complaining of acute onset of epigastric pain, nausea, vomiting and anorexia. From these observations I concluded that acute gastritis can be classified into three similar and yet separate types edema, hemorrhagic erosion and acute ulceration types.

　Edema type: X-ray and endoscopy showed edema of the mucosa and marked swelling of the folds, extending from the antrum up to the region of the angle.

　Hemorrhagic type: This type was characterized by edematous thickening of the mucosal folds, likewise extending from the antrum up to the region of the angle, in addition to hemorrhage and erosion.

　Acute ulceration type: X-ray revealed noticiable rigidity and filling defect on the antral margin along the greater and lesser curvature, due to thickening of the mucosa. Endoscopy revealed hemorrhagic erosion and ulceration of the antrum.

　Acute gastritis in our study occurred most frequently in December. Of the fifty-two patients observed, thirty were males and twenty, females. One predisposing factor was eating raw fish, especially of raw mackerel, but on most occasions specific causes remained undetermined.

　Prognosis was usually good; most of the patients recovered within a few weeks, but some cases in the ulceration type showed definite scarring even after several months.