Deformity of duodenal bulb, gastric metaplasia of duodenal regenerating mucosa and recurrence of duodenal ulcer: a correlated study.
OBJECTIVE
To investigate the correlation among the presence and degree of gastric metaplasia of duodenal regenerating mucosa, the deformity of bulb and the recurrence of duodenal ulcer.


METHODS
A total of 99 patients with duodenal ulcer were treated with H(2)-antagonist with or without antimicrobial therapy. All patients received follow-up endoscopic examinations 6 wk after treatment. When the ulcer(s) were noted to be healed, two biopsies were taken from the ulcer scar for histological study of gastric metaplasia, and 4 biopsies were taken from antrum for Helicobacter pylori (H pylori) study. Out of these cases, 44 received further follow-up endoscopic examinations after 3, 6 and 12 mo respectively for studying the recurrence rate of duodenal ulcers. The correlation among ulcer recurrence, degree of gastric metaplasia of regenerating mucosa, bulbar deformity, and colonization of H pylori in the stomach was then studied.


RESULTS
The results showed that there was a strong correlation between the deformity of duodenal bulb and the degree of gastric metaplasia of regenerating duodenal mucosa. The recurrence rate of duodenal ulcer had a significant difference between patients with and without H pylori colonization in the stomach (P<0.001). The greater the degree of gastric metaplasia of duodenal regenerating mucosa, the higher the recurrence rate of duodenal ulcer (P = 0.021). The more deformed the duodenal bulb, the higher the incidence of recurrence of duodenal ulcer (P = 0.03).


CONCLUSIONS
There is a correlation among deformity of duodenal bulb, gastric metaplasia of duodenal regenerating mucosa and recurrence of duodenal ulcer. A more severely deformed duodenal bulb is closely related to a greater extent of gastric metaplasia. Both factors contribute to the recurrence of duodenal ulcer.
Chang
Chun-Chao
CC
Department of Internal Medicine, Taipei Medical University Hospital, No 252, Wu-Hsing Street, Taipei 110, Taiwan, China.
Pan
Shiann
S
Lien
Gi-Shih
GS
Liao
Cheng-Hsiung
CH
Chen
Sheng-Hsuan
SH
Cheng
Yeong-Shan
YS
D000293:Adolescent; D000328:Adult; D000368:Aged; D004381:Duodenal Ulcer / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D004386:Duodenum / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D005756:Gastritis / Q000150:complications / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000473:pathology; D016480:Helicobacter pylori; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D012008:Recurrence
D006635:Histamine H2 Antagonists