Chronic erosions of the stomach--a clinical, endoscopic and histological evaluation.
A clinical, endoscopic and histological study was performed in 300 patients with chronic gastric erosions. The male-female ratio was 4:1. The antrum was the preferential site of erosions. Chronic erosions were classified into two categories: "active" (with a dark clot or whitish coat of fibrin) and "inactive" (covered by a normal pink mucosa). All the lesions showed foveolar hyperplasia, partial obliteration of the lamina propria by fibrous and smooth muscle bundles, a greatly thickened muscularis mucosae and an increased number of submucosal thick-walled vessels. In the "active" stage the central umbilicated area was covered by a collection of granulocytes, while in some of the "inactive" erosions the central depression showed the presence of a channel-like structure penetrating into the lamina propria. In two cases the lesion mimicked a gastric adenomyoma. Gastric acid secretion was significantly increased in the tested patients as compared with normal. The similarity of the histological findings with those in ischemic conditions of the gastro-intestinal tract suggests that both hypersecretion and localized ischemia may play a role in the pathogenesis of chronic erosions.
D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D005500:Follow-Up Studies; D005744:Gastric Acid / Q000378:metabolism; D005753:Gastric Mucosa / Q000473:pathology; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum / Q000473:pathology; D013272:Stomach Diseases / Q000150:complications / Q000378:metabolism / Q000473:pathology*