J.Jpn. Surg. Soc.. 87(9): 1144-1147, 1986

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Report on the annual meeting

PROGRESS IN THE TREATMENT OF PEPTIC ULCER

The healing rate of peptic ulcer in the medical therapy has been markedly improved since the use of histamine H₂-receptor antagonists (H₂-blocker).
However, we encounter intractable ulcers for medication and relapsing ulcers with complications as before. These intractable and relapsing ulcers are the most important problems in the therapy of peptic ulcer and it is considered that those ulcers should be indicated to surgical treatments. But we had not how to decide the direction of medical therapy or surgical treatment on the diagnosis of peptic ulcer.
So, we tried to use endoscopic ultrasonography (EUS) for the analysis of peptic ulcer. EUS showed clearly the layer of gastric wall and visualized ulceration with edema on the usual peptic ulcer. But intractable and relapsing ulcers were accopanied with marked fibrous changes under the ulceration and revealed penetrated ulcers by EUS. We considered that these intractable and relapsing ulcers need to have surgical treatments prospectively.
It is concluded that the use of EUS is the most important method for the decision of the treatment on the diagnosis of peptic ulcer.

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