Relations between Gastric Mucosal Red Striae and Acute Gastric Mucosal Lesions:—With Special Reference to Changes in Gastric Mucosal Microcirculation and Autonomic Nerve Endings—

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A study was made of acute gastric mucosal lesions observed after upper GI endoscopic procedures. To determine relations between red striae and acute gastric mucosal lesions, biopsies were taken from erythematous areas with red striae, and mucosal microcirculation and autonomic nerve endings were examined under an electron microscope. Alterations of endothelial cells in deep mucosal layer and axonal endings, which extended to surrounding interstitial tissues, were observed. In contrast, these tissues showed only slight and partial alterations in cases where red striae did not progress to acute gastric mucosal lesions. In experiments on rats immersed and constrained in water, mucosal never axon endings had decreased nerve granules and vacuolation at an early stage of stress. Microvascular endothelial cells also showed vacuolar degeneration. Interstitial alterations occurred mainly in micro blood vessels in the lamina propria mucosae when additional stress was applied. Acute gastric mucosal lesions are believed to be caused by microvascular dysfunction at an early stage, and if this dysfunction persists or is aggravated, red striae are very likely to progress to acute gastric mucosal lesions. Findings in the present study suggest that, under conditions likely to produce stress, acute gastric mucosal lesions may be caused by stress due to endoscopy.
昭和大学・昭和医学会の論文