Antrum Hyperfunction and Gastric Ulcer

Dragstedt, Lester R.; Oberhelman, Harry A.; Evans, Shirl O.; Rigler, Stanley P.

doi:10.1097/00000658-195409000-00015

Cited by 54 publications

(6 citation statements)

References 6 publications

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“…The use of vagotomy and pyloroplasty for gastric ulcer is based on the original concept of Dragstedt and others, that gastric ulcer is essentially due to pyloric obstruction (Dragstedt et al , 1954; Dragstedt, 1956; Burge, 1960, 1964, 1966; De la Rosa et al , 1964). The subsequent antral retention and enhanced gastrin production result in increased acid‐pepsin secretion and consequent ulceration.…”

Section: Discussionmentioning

confidence: 99%

Indications for Conservative Surgery in Gastric Ulcer

Lewis

Qvist

1971

Int J Clinical Practice

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Section: Discussionmentioning

confidence: 99%

Indications for Conservative Surgery in Gastric Ulcer

Lewis

Qvist

1971

Int J Clinical Practice

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“…Also the submucosal fibrosis may well interfere with innervation. It seems unlikely that abnormal production of hormone is responsible for the development of a gastric ulcer (for an opposing view see Dragstedt et al, 1954).…”

Section: Classification Of the Inflammatory Changes Thementioning

confidence: 99%

The antrum in patients with duodenal and gastric ulcers.

Schrager¹,

Spink²,

Mitra³

1967

Gut

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EDITORIAL COMMENT In this histological study of surgical specimens it has been shown that duodenal ulcer is associated with mild inflammation and gastric ulcer with marked changes and degeneration with metaplasia.Very few detailed descriptions of the antrum are available in the literature, yet the importance of this organ has been stressed by many writers in the past (Konjetzny, 1928;Faber, 1935;Hebbel, 1943; Magnus, 1954;Dean and Mason, 1964; and others). An attempt has been made in this laboratory to study the gastric antrum in normal stomachs and in duodenal and gastric ulcer in greater detail. METHODSOne hundred and thirty specimens were examined. Seventy-five of these were surgical specimens from cases of duodenal ulcer and 40 from cases of gastric ulcer. Sixteen were from post-mortem specimens removed within a few hours of death, in which as far as could be ascertained, there was no question of gastrointestinal disease. The surgical specimens were opened immediately after operation by cutting along the greater curvature and they were pinned out with care on cork mats. They were formalin fixed immediately. The specimens with duodenal ulcer had a cuff of duodenum some 5 cm. in width. The amount of duodenum in gastric ulcer specimens was much reduced, but all the specimens showed an intact sphincter. The proximal portion of the specimen consisted of gastric mucosa.After fixation, the specimens were photographed. The size of the photograph was exactly the same as the size of the stomach. A tracing was made from the photograph onto thin paper. The whole of the specimen was cut into longitudinal strips 1-Ij cm. broad. Transverse cuts were then made through the strips at three places, the result being 30-40 shorter pieces measuring approximately 6 cm. in length. A plan of these cut strips was made on the tracing from the stomach. The strips were numbered and these numbers entered on the plan. The strips were then processed, blocked in wax, and sectioned on a sledge microtome. The boundary between the antrum and the body mucosa was studied and mapped out and the surface area of the antrum measured with a planimeter. This procedure enabled us to study thoroughly all of the gastric mucosa and get acquainted with the whole of its cellular topography.The stains used in this study were haematoxylin and eosin and Zimmerman's stain using the method described by Marks and Drysdale (1957); also 30 specimens were stained with Van Gieson stain. The Zimmerman stain was used to show up well the parietal, peptic, and mucous cells. The Van Gieson stain was used to show the increase in fibrous tissue in the mucosa and submucosa. RESULTS CLASSIFICATION OF THE INFLAMMATORY CHANGES Theinflammatory changes in the antral mucosa were classified as follows: 1 Changes showing inflammatory reaction and no destruction of pyloric glands, and according to severity, divided into grades Al and A2 (Figs. 1 and 2); 2 changes resulting in damage and destruction of the pyloric glands with increasing amounts of intestinalization. The final stage s...

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“…With proximal gastric ulceration it has been suggested that the ulceration is secondary to the pyloric stenosis (McCann and Dean, 1950;Dragstedt, Oberhelman, Evans, and Rigler, 1954;Johnson, 1955;Skoryna et al, 1959), and Christiansen and Grantham (1962) considered that the stenosis might also be the cause of the hypertrophic gastritis and polyposis. But this does not explain the pyloric hypertrophy any more than why a small proportion of -patients with duodenal or pyloric canal ulcers are found to have it, nor why biliary tract disease or hiatus hernia has been found in about 17% of patients with simple pyloric hypertrophy (Christiansen and Grantham, 1962).…”

Section: Aetiologymentioning

confidence: 99%

Simple and complicated hypertrophic pyloric stenosis in the adult

Wm¹

1965

Gut

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Antrum Hyperfunction and Gastric Ulcer

Cited by 54 publications

References 6 publications

Indications for Conservative Surgery in Gastric Ulcer

Indications for Conservative Surgery in Gastric Ulcer

The antrum in patients with duodenal and gastric ulcers.

Simple and complicated hypertrophic pyloric stenosis in the adult

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