重蹇普科大学 ngging Medical University Chronic peptic ulcers Peptic ulcers are chronic,most often solitary,lesions that occur in any portion of the gastrointestinal tract exposed to the aggressive action of acid-peptic juices. At least 98%of peptic ulcers are either in the first portion of the duodenum or in the stomach,in a ratio of about 4:1
Chronic peptic ulcers Peptic ulcers are chronic, most often solitary, lesions that occur in any portion of the gastrointestinal tract exposed to the aggressive action of acid-peptic juices. At least 98% of peptic ulcers are either in the first portion of the duodenum or in the stomach, in a ratio of about 4:1
重废陪科大昂 1.Morphology All peptic ulcers,whether gastric or duodenal,have an identical gross and microscopic appearance. Grossly,most are round,sharply punched- out craters 2 to 4 cm in diameter but they may be larger and can exceed 10cm in diameter .The margins of the crater are perpendicular and there is some mild edema of the immediately adjacent mucosa,but unlike ulcerated cancers there is no significant elevation or beading of the edges
1.Morphology All peptic ulcers, whether gastric or duodenal, have an identical gross and microscopic appearance. Grossly, most are round, sharply punchedout craters 2 to 4 cm in diameter but they may be larger and can exceed 10cm in diameter .The margins of the crater are perpendicular and there is some mild edema of the immediately adjacent mucosa, but unlike ulcerated cancers there is no significant elevation or beading of the edges
重麦等科大学 ongging Medical University The surrounding mucosal folds may radiate like wheel spokes.The base of the crater appears clean,owing to peptic digestion of the inflammatory exudate and necrotic tissue. If the ulcer crater penetrates through the duodenal or gastric wall,a localized or generalized peritonitis may develop. Alternatively,the perforation is sealed by an adjacent structure such as adherent omentum, liver,or pancreas
The surrounding mucosal folds may radiate like wheel spokes. The base of the crater appears clean, owing to peptic digestion of the inflammatory exudate and necrotic tissue. If the ulcer crater penetrates through the duodenal or gastric wall, a localized or generalized peritonitis may develop. Alternatively, the perforation is sealed by an adjacent structure such as adherent omentum, liver, or pancreas
烟童走普科大导 gqing Med山eal Univer
重蹇普科大学 ongging Medical University Microscopically, four zones can be distinguished (1)the base and margins have a thin layer of necrotic fibrinoid debris underlain by (2)a zone of inflammatory infiltration with neutrophils predominating,underlain by (3)granulation tissue,deep to which is (4)fibrous,collagenous scar that fans out widely from the margins of the ulcer.Arteries within this fibrous base often show extreme narrowing of their lumina by intimal proliferation (endarteritis obliterans)
Microscopically, four zones can be distinguished (1) the base and margins have a thin layer of necrotic fibrinoid debris underlain by (2) a zone of inflammatory infiltration with neutrophils predominating, underlain by (3) granulation tissue, deep to which is (4) fibrous, collagenous scar that fans out widely from the margins of the ulcer. Arteries within this fibrous base often show extreme narrowing of their lumina by intimal proliferation (endarteritis obliterans)