Kagawa T
Third Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Nihon Ika Daigaku Zasshi. 1990 Dec;57(6):547-55. doi: 10.1272/jnms1923.57.547.
Clinical significance of endoscopic examination in acute corrosive gastritis were evaluated. Serial endoscopic observations were made in men and rabbits with acute corrosive gastritis. The endoscopic findings were matched against the histological features. The most characteristic endoscopic finding was a brown coloration of the mucosa. Histologically, this corresponded to gangrenous mucosa which was accompanied by necrosis of the gastric wall throughout its entire thickness. When the brown coloration of the mucosa became extensive, chemical peritonitis was induced by the leakage of caustic solution through the wall of the stomach. The recognition of this brown coloration of the mucosa was often hampered by blood coagulo -adhering to the mucosa or brown coloration of the mucosa caused by hematin formation. The latter disappeared 3-6 days after the ingestion of corrosives. It was concluded that endoscopic examination in patients with acute corrosive gastritis should be performed to permit accurate recognition of brown coloration of the mucosa 4-7 days after the ingestion of corrosives.
评估了内镜检查在急性腐蚀性胃炎中的临床意义。对患有急性腐蚀性胃炎的男性和兔子进行了系列内镜观察。将内镜检查结果与组织学特征进行匹配。最具特征性的内镜检查发现是黏膜呈褐色。组织学上,这对应于坏疽性黏膜,伴有胃壁全层坏死。当黏膜褐色变广泛时,苛性溶液通过胃壁渗漏可引发化学性腹膜炎。黏膜褐色变的识别常因血凝块附着于黏膜或因含铁血黄素形成导致的黏膜褐色变而受阻。后者在摄入腐蚀性物质后3 - 6天消失。得出的结论是,对于急性腐蚀性胃炎患者,应在摄入腐蚀性物质后4 - 7天进行内镜检查,以准确识别黏膜的褐色变。