山口医学

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山口医学 Volume 37 Issue 3
published_at 1988-06

Endoscopic studies of duodenal linear ulcer

十二指腸線状潰瘍の発生と経過に関する内視鏡的研究
Kawashima Masao
Descriptions
4172 cases of duodenal ulcer diagnosed by endoscopy for ten years from 1971, were divided into 5 types by a location and a shape of ulcer. These were single (2282 cases, 54.7%), kissing (631 cases, 15.1%), double (595 cases, 14.3%), linear (387 cases, 9.3%) and multiple ulcer (227 cases, 6.6%) [Table 1]. And ”circular line ulcer”, which is so elongated as to extend to almost the entire circumference of the wall, causing ring-like deformity of the bulb, was observed in 12 cases (3.1%). The conclusions of this endoscopic study of duodenal liner ulcer were as follows. 1) Duodenal linear ulcer can be diagnosed endoscopically, when it's length is more than one fourth of the mural circumference of deodenal bulb. This definition was a proper for linar ulcer on this study. 2) The proportion of linear ulcer in elder group was higher than in younger group [Figure 1]. 3) There were no significant differences in both of basal acid output (mEq/hr.) and maximal acid output (mEq/hr.), between linear ulcer group and others [Table 3]. 4) Endoscopic atrophic border by Congo-red solusion was examined. Some of patients with linear ulcer showed open type [Table 4], but there were no significant differences. 5) Microscopic findings of resected duodenal linear ulcer showed deep ulcers at the both terminals of ridge, and showed relative shallow ulcer on the center of ridge [Figure 7, 8]. 6) Most of duodenal linear ulcer were found on the top pf ridge and the oral side of circular stenosis. These position may be much affected by any physical stimuli. Deformity of deodenal bulb maly be necessary to a formation of linear ukcer.