The antrum in patients with duodenal and gastric ulcers.

Abstract

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...

Gastric corpus IL‐8 concentration and neutrophil infiltration in duodenal ulcer patients

“…In general, duodenal ulcer patients are known to have high acid secretion, 18,19 and fewer DU patients have been reported to have histological gastritis in the body in comparison with those who do not have ulcer or those who have gastric ulcer. 20,21 This was assumed by Solcia et al 20 to be attributable to the possibility of attenuation of the damage caused by H. pylori on the mucosa through the transformation from ammonia to ammonium chloride by acid. There is also a report that DU patients do not often develop corporal gastritis because the amount of H. pylori in the body of the stomach of these patients is lower.…”

Peptic Disease in Childhood in Asir Province

“…Peptic ulcer in children is usually of the secondary type such as stress ulcer in early infancy, but with older children it tends to be the primary type, which has been associated with histologic evidence of chronic active antral gastritis. 2,3 The presentation varies with age; it can present with massive brisk bleeding in early infancy and toddlers present with decreased appetite and poor feeding. 4 The usual presentation beyond the toddler age is abdominal pain, but gastric outlet obstruction in the form of projectile vomiting or hematemesis has been documented.…”

Campylobacter pylori and gastroduodenal disease

“…Over the years several factors, including genetic predisposition, smoking, and acid secretion, have been found to be associated with ulcer development. It has also been known for some years that patients with ulcers have gastritis (32,52,116), a fact that has taken on new significance with reports of bacteria being present.…”

“…Even before the recognition of C. pylori, it was known that gastritis occurred in peptic ulcer patients (116) 3,1990 on May 11, 2018 by guest http://cmr.asm.org/ Downloaded from over, the relapse rate for ulcers had been shown to be lower in patients treated with bismuth compounds than in those treated with H2 blockers (66,129). The discovery of C. pylori provided a plausible explanation for these observations.…”