Surgical and pathologic aspects of protein losing gastropathy.

The mechanism of protein loss from the gastric wall was investigated in patients with Ménétrier's disease, gastric polyps, and carcinoma of the stomach. In Ménétrier's disease, plasma protein was lost as glycoprotein in the gastric juice secreted from proliferated foveolar cells. Some of the gastric polyps also showed pathologic findings similar to that of Ménétrier's disease. As a treatment for the diffuse type of Ménétrier's disease, subtotal gastrectomy was recommended by presenting enough recovery from hypoproteinemia. A small amount of protein lost from the remaining portion of the stomach may be almost completely digested and reabsorbed from the intestine. In instances of carcinoma of the stomach, the mechanism of protein loss was speculated to be loss of lymph, blood or other interstitial fluids from opened capillaries of the cancerous surface. Complete removal of the carcinoma, therefore, certainly results in recovery from hypoproteinemia.