Saito J
Nihon Heikatsukin Gakkai Zasshi. 1978 Sep;14(3):105-18. doi: 10.1540/jsmr1965.14.105.
Clinically, it is true that gastric ulcer is more common along the lesser curvature and less common along the greater curvature. To elucidate this difference in ulcerognesis, two experimental ulcers were prepared in dogs at the sites, one at the angular incisure and the other at the corresponding greater curvature after the method by Hatafuku & Thal. The fates of these ulcers studied endoscopically, macroscopically, histologically and with the use of microangiography. The results obtained are summarized as follows. 1) When two ulcers only were prepared, better healing was consistent for the greater curve ulcer. 2) Experimental ulcers with simultaneous ligation of gastric vessels resulted in poor healing of both ulcers, though the greater curve ulcer showed better healing than the lesser curve ulcer. 3) Endoscopically, dogs with vessel ligation showed antral congestion and edema. These findings, however, disappeared in 3 to 4 weeks. 4) Histamine injection accelerated the rate of early perforation and both experimental ulcers showed no tendency of healing. In conclusion, delayed healing was almost consistent for the lesser curve ulcer under various conditions. The cause for this may be explained by the increased motility with repeated ischemic condition at the lesser curvature.
临床上,胃溃疡确实在胃小弯处更为常见,而在胃大弯处则较少见。为了阐明溃疡发生过程中的这种差异,按照Hatafuku和Thal的方法,在犬的胃小弯角切迹处和相应的胃大弯处制备了两个实验性溃疡。通过内镜检查、宏观检查、组织学检查以及微血管造影术对这些溃疡的转归进行了研究。所得结果总结如下:1)仅制备两个溃疡时,胃大弯溃疡愈合得更好。2)同时结扎胃血管的实验性溃疡,两个溃疡愈合均较差,不过胃大弯溃疡比胃小弯溃疡愈合得更好。3)在内镜下,结扎血管的犬出现胃窦充血和水肿。然而,这些表现在3至4周内消失。4)注射组胺加快了早期穿孔的速度,两个实验性溃疡均无愈合倾向。总之,在各种情况下,胃小弯溃疡的愈合延迟几乎是一致的。其原因可能是胃小弯处反复出现缺血状态,导致蠕动增加。