:A Clinical and Experimental Study on the Natural History of Gastric Ulcer

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The reason of alteration of acute gastric lesion into chronic gastric ulcer or the process of development of chronic gastric ulcer is still unknown. In order to solve this problem we performed follow-up studies of acute gastric lesions using endoscopes in clinical cases. We also attempted to observe the natural history of chronic gastric ulcers, experimentally produced in rats by two methods designed by us for this prupose.The clinical material consisted of a total of 397 gastric lesions, including hemorrhagic erosions, trench ulcers, acute kissing ulcers in the antrum, which were followed for 3 to 19 months. The lesions were located near the cardia in 17 cases (4.3%), at the body in 123 (31.0%), at the angulus in 77 (19.4%), and at the antrum in 180 (45.3%). Most of the acute gastric lesions showed rapid healing without changing into chronic open ulcer, but some lesions at the fundopyloric border (FP-border) exhibited delayed healing or recurred though rarely.In the Experiment I gastric mucosal defects were formed in rats in various locations, sizes and depths. It was then found that no erosions changed into chronic ulcer. On the other hand, all Ul-II over 7×7mm in size at the FP-border were found to become chronic gastric ulcers up to 540 days. In the Experiment II, the entire gastric mucosa was destructed by application of caustic soda. In its healing process, multiple or linear ulcers were formed only at the FP-border.In conclusion, alteration of acute gastric lesions into chronic ulcer seems to require certain circumstances as follows;(1) the size over certain degree, (2) the depth over Ul-II and (3) the localizationn at the FP-border.
財団法人日本消化器病学会の論文

:A Clinical and Experimental Study on the Natural History of Gastric Ulcer

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