Pathophysiology of the gastric microcirculation.
Mucosal blood flow performs an extremely important role in microcirculation wherein alterations necessarily lead to severe gastric and duodenal mucosal lesions. The removal of back-diffused H+ ions through the adaptation of microcirculatory flow represents a valid defence mechanism. The blood flow's inability to contain H+ back-diffusion lies at the bottom of rapid-onset acute mucosal lesions; moreover, it probably contributes to the onset of chronic ulcer in certain areas already precariously supplied, because of the breakdown of the mucosal barrier or a further reduction in blood supply. Portal hypertension leads to altered blood flow in the gastric microcirculation. This haemo-dynamic condition brings about a series of endoscopically evident changes which are probably a consequence of the conspicuous increase in mucosal and submucosal vascular area. This haemodynamic situation may be an aetiopatho-genetic factor in the cirrhotic subject's marked sensitivity to gastric mucosal damage.
Vigneri
S
S
Istituto di Medicina Interna e Geriatria, Università di Palermo, Italy.
Scialabba
A
A
Termini
R
R
Germanà
B
B
Vianello
F
F
Grassi
S A
SA
Plebani
M
M
Di Mario
F
F
D000818:Animals; D002908:Chronic Disease; D004195:Disease Models, Animal; D005753:Gastric Mucosa / Q000098:blood supply* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D006975:Hypertension, Portal / Q000473:pathology / Q000503:physiopathology*; D007511:Ischemia / Q000473:pathology / Q000503:physiopathology*; D008833:Microcirculation / Q000473:pathology / Q000503:physiopathology; D051381:Rats; D012039:Regional Blood Flow; D013276:Stomach Ulcer / Q000473:pathology / Q000503:physiopathology*