胃出血性びらん時の十二指腸球部・球後部および下行脚部の内視鏡所見

Endoscopic Findings of the Duodenal Bulb and Postbulbar Segments at the Time of Hemorrhagic Erosion of the Stomach

　われわれは，これまで数次にわたって激しい上腹部痛を訴えて第一線診療所に来診する患者に対して，ただちに胃のファイバースコープ検査を行なうと，予想より高い頻度に急性びらんの極期である出血性びらんを見出すこと，ならびにそれに関する種々の所見について報告した．これらの知見を総合すると，

　1）出血性びらんの発生部位は胃の幽門部に多いが胃体部にも稀ではない．

　We have encountered during the past ten years 350 cases of gastric hemorrhagic erosion (H. E.) to be regarded as either manifestation of the climax of acute gastric erosion or its antecedent lesion displaying black spots on the mucosa. Of these, there were 66 cases in which the duodenum was additionally observed by endoscopy. In 14 of them black or dark brown spots were demonstrated in both the stomach and duodenum. On the other hand, H. E. in the duodenum alone, as is shown in Case 1, is of far rarer occurrence. A fairly long and enduring study seems necessary before one chances to come across such a case. So far we have experienced only 2 including the case mentioned above. Cases 2, 3 and 4 are examples of those characterized by quite a number of black spots in the stomach; the duodenum mostly showing a picture of transition into acute erosion because some of the black spots had already come off. When a fiberscope was introduced in the same stage further down into the descending limb of the duodenum, multiple erosions were quite unexpectedly detected in this segment as well. A lesion of this kind in an acute stage has never been revealed for observation.