Sogge M R, Butler M L
J Clin Gastroenterol. 1981 Mar;3(1):13-5. doi: 10.1097/00004836-198103000-00003.
Previous reports of benign gastric ulcer with achlorhydria have recommended surgical removal of the ulcer, even though a malignant process had not been demonstrated. We report a patient with achlorhydria and a gastric ulcer who, at exploration 4 weeks after discovery, had only a healed ulcer. Its benign nature was demonstrated by endoscopic biopsies and cytology and confirmed at surgery. The patient has remained achlorhydric on follow-up and has not had further ulcers. We recommend that, after multiple endoscopic biopsies and cytology have adequately excluded a malignant process, a gastric ulcer be followed to complete healing, even in the presence of achlorhydria. If healing is incomplete by 6-12 weeks, surgical intervention should be contemplated, just as for more routine gastric ulcers.
以往关于无胃酸的良性胃溃疡的报告建议，即使未证实存在恶性病变，也应对溃疡进行手术切除。我们报告了一名患有无胃酸和胃溃疡的患者，在发现溃疡4周后进行探查时，仅发现一个已愈合的溃疡。内镜活检和细胞学检查证实其为良性，手术也予以了确认。该患者在随访中一直无胃酸，未再出现溃疡。我们建议，在多次内镜活检和细胞学检查充分排除恶性病变后，即使存在无胃酸情况，也应对胃溃疡进行随访直至完全愈合。如果6 - 12周仍未完全愈合，则应考虑手术干预，就如同处理更常见的胃溃疡一样。
