Stolte M, Gail K, Mihaljevic L
Institut für Pathologie, Klinikum Bayreuth.
Z Gastroenterol. 1991 Sep;29(9):426-8.
In a 32-year-old woman with an ulcer that had persisted for more than 13 months despite treatment with the H2 blocker ranitidine, the latter was replaced by the H+K(+)-ATPase inhibitor omeprazole. Treatment with omeprazole also failed to bring about healing of the ulceration which, at times, measured up to 10 cm in diameter. On account of a hemorrhage from the ulcer, a Billroth II resection of the stomach had to be performed. The histological work-up of the surgical specimen confirmed the tentative diagnosis of a secondary ulceration in underlying eosinophilic gastritis established on the basis of the work-up of biopsy material obtained from the ulcer. The reason for the failure of the lesion to respond to the H2 blocker or omeprazole in this case was a diffuse infiltration of the antral wall with eosinophilic granulocytes, and the resulting secondary persistent ischaemic ulceration.
一名32岁女性患有溃疡，尽管使用H2受体阻滞剂雷尼替丁治疗，但溃疡持续超过13个月，随后将雷尼替丁换为H⁺K⁺-ATP酶抑制剂奥美拉唑。使用奥美拉唑治疗也未能使溃疡愈合，溃疡直径有时可达10厘米。由于溃疡出血，不得不进行胃毕Ⅱ式切除术。手术标本的组织学检查证实了根据溃疡活检材料检查初步诊断的潜在嗜酸性粒细胞性胃炎继发溃疡。在这种情况下，病变对H2受体阻滞剂或奥美拉唑无反应的原因是胃窦壁被嗜酸性粒细胞弥漫浸润，以及由此导致的继发性持续性缺血性溃疡。
