By J. M. Naish
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Extra resources for Basic Gastro-Enterology. Including Diseases of the Liver
Since antral ulcers are often malignant, and since differentiation may be difficult, it is wise to advise immediate treatment for all ulcers in this position if the radiological and gastroscopic findings are at all equivocal. Even if an antral ulcer has all the appearances of simplicity, medical treatment must be followed to a conclusion—complete healing of the ulcer within six weeks. If this is not achieved gastrectomy should be advised. If the ulcer is on the lesser curvature the same principle is followed, but since there is less likelihood of cancer, some physicians consider it permissible to persist with conservative treatment even though the ulcer has not healed.
If an erosion extends through the muscularis mucosa it is regarded as an acute gastric ulcer. Chronic atrophic gastritis is of all degrees of severity, but can be divided arbitrarily into two groups: (1) Partial atrophic gastritis; (2) Complete atrophic gastritis. 36 BASIC GASTROENTEROLOGY In the first, although glandular atrophy and destruction have advanced far, the mucosa is not substantially thinned, because the intestinal tissue is heavily infiltrated by cells, of which plasma cells predominate in the outer layers, and lymphocytes close to the muscularis.
7) are :— ι. Oxyntic or parietal cells which produce hydrochloric acid. Found in fundic glands. Stain red with eosin. 2. Body chief cells which produce pepsin. Found deep in fundic glands. 3. Cells producing mucus are: (a) Epithelial surface cells, (b) Cells of the neck of the fundic glands, (c) Cells of pyloric antral glands. m u c o s a l a s p e c t of s t o m a c h opened along greater curvature Fig. —Distribution of fundic and antral mucosa. T h e distribution of these cells is partly zonal, the parietal cells and the body chief cells being concentrated in the fundus of the stomach, whereas the antral glands are entirely mucus-secreting.
Basic Gastro-Enterology. Including Diseases of the Liver by J. M. Naish