J.Jpn. Surg. Soc.. 60(14): 2133-2152, 1960
PATHOLOGICAL AND CLINICAL STUDIES ON THE SYMMETRICAL STOMACH ULCER
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Surgical Department, Showa Medical School (Director: Prof. T . Murakami) Takematsu SUZUKI |
Among the 277 stomach ulcers, 75 symmetrical ulcers were found, which rate was 33%. Then, pathological and clinical studies were performed, and they were compared with round ulcers. Consequently, some characteristics of the symmetrical ulcer has been obtained, especially in pathology, clinical course, and roentgenology.
The results obtained were as follows:
1) The frequency of the symmetrical ulcer was 33% among all gastric ulcers
2) They were composed of 89% of linear ulcer and 11% of kissing ulcer.
3) The linear ulcers develop by the repeat of ulceration and making scar.
4) The distance between ulcer and pyloric ring was very closely related with the length of the linear ulcer. Namely, the longer is the length of ulcer, becomes the shorter the distance.
5) From these facts, it was presumed that, if the linear ulcer develops at high position of the stomach, it would increase its length, and shorten the distance between pyloric ring and ulcer. The shortening of the distance is caused by the atrophy of the pyloric anthrum.
6) The stomach with linear ulcer had a liability to be pyloric stenosis, and the stomach with kissing ulcer was liable to be hour -glass stomach.
7) Most of the symmetrical ulcers begin in the younger individuals with very long clinical courses until operations performed.
8) Generally, most of the patients of the symmetrical ulcers had no sudden symptoms and their sickness were progressively.
9) The patients of the symmetrical ulcers generally complain of stenotic symptoms of the stomach.
10) The delay of discharge of test fluid has been observed by the examination of gastric juice.
11) Roentgenologically, it was difficult to find profile niche in the case of symmetrical ulcer.
12) The shortening of the lesser curvature and disappearance of the incisura angularis for instance, purs-like stomach was proved to be the best sign to diagnose the linear ulcer, on the contrary the hour-glass stomach sometimes indicates the kissing, ulcer of the stomach.
(Author's abstract)
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