Colletti R B, Trainer T D
Department of Pediatrics, University of Vermont College of Medicine, Burlington.
Gastroenterology. 1989 Dec;97(6):1552-5. doi: 10.1016/0016-5085(89)90403-4.
Subepithelial fibrosis has previously been reported in the small intestine (collagenous sprue) and colon (collagenous colitis). We report a 15-yr-old girl with chronic gastritis and subepithelial fibrosis of the gastric corpus who presented with recurrent abdominal pain and acute upper gastrointestinal bleeding. Nodularity and erythema of the gastric corpus were persistent endoscopic findings. Biopsies revealed patchy chronic active gastritis with a striking focal thick band of collagen immediately beneath the surface epithelial cells that did not extend to deeper portions of the lamina propria. Contrast radiography demonstrated an abnormal mucosa of the gastric corpus with a mosaiclike surface pattern. Numerous studies have failed to elucidate the etiology. Despite treatment with ranitidine, sucralfate, and furazolidone, there has been no clinical or pathologic improvement. The pathogenesis and prognosis of collagenous gastritis, and its relationship to collagenous sprue and collagenous colitis, remain to be defined.
上皮下纤维化此前在小肠(胶原性口炎性腹泻)和结肠(胶原性结肠炎)中已有报道。我们报告了一名15岁女孩,患有慢性胃炎和胃体上皮下纤维化,表现为反复腹痛和急性上消化道出血。胃体的结节状和红斑是持续的内镜检查发现。活检显示为斑片状慢性活动性胃炎,在表面上皮细胞下方有一条明显的局灶性增厚胶原带,未延伸至固有层深层。对比造影显示胃体黏膜异常,呈马赛克样表面图案。众多研究未能阐明其病因。尽管使用雷尼替丁、硫糖铝和呋喃唑酮进行了治疗,但在临床或病理方面均无改善。胶原性胃炎的发病机制和预后,及其与胶原性口炎性腹泻和胶原性结肠炎的关系,仍有待明确。