[A case of lipoma of the stomach prolapsing into the duodenal bulb and causing a duodenal ulcer].
Tateki YamaneKan UchiyamaToru FuruyaTakayuki IshiiNobuo OmuraMasataka NakanoShinsuke FUKAMACHITatsushi SuwaToshifumi Okusa
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Abstract:
We report a case of lipoma in the antrum of the stomach which prolapsed into the duodenal bulb and caused a duodenal ulcer, which was speculated to have been induced by the friction of its tip against the duodenal mucosa. Although the duodenal ulcer healed after the administration of a proton pump inhibitor, the symptoms of epigastric discomfort continued, which was suggested to be due to the prolapse. Therefore, a laparoscopic operation was conducted. The incidence of lipoma of the stomach is rare, and cases of its prolapse into the duodenum are few. Furthermore, it is extremely rare for it to cause a duodenal ulcer. Because these features made this case clinically interesting, we report it here.Keywords:
Duodenal bulb
Gastric antrum
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The mucosal distribution of G cells was quantitatively mapped in resected stomachs from 42 patients (12 with gastric ulcer, 11 with duodenal ulcer, 14 with duodenal ulcer and uremia, and 5 with gastric cancer). Along the histological border of the proximal part of the pyloric antrum there was in all patient categories a transitional zone of varying extent, with a low G-cell density before the cells disappeared in the body of the stomach. The proximal end of the duodenum contained considerably fewer G cells than the antrum, and the number was virtually equal in all groups. Within the antrum there was in the material as a whole a gradual increase in G-cell density from the proximal to the distal part, but this difference was not apparent for the gastric ulcer patients. When corresponding antral segments were compared between the various patient groups, the G-cell density was found to be significantly decreased in the distal antrum of the gastric ulcer patients. In all patient categories, except the duodenal ulcer group with uremia, the circumferential distribution of G cells showed reduced density along the curvatura minor. For the material as a whole there were great individual variations in the overall antral G-cell density, in the antral area corresponding to the distribution of G cells and in the total G-cell mass; these three variables were not significantly related to diagnosis, age or sex.
Pyloric Antrum
Uremia
Gastric antrum
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Morphological changes were studied of gastritis in patients with ulcer localized in the upper, middle thirds of the stomach, in its antral segment, and in patients with ulcer in the bulb of duodenum, the former two groups of patients displaying mild inflammation/activity if any, the latter ones showing a high to moderate degree of inflammation and activity of gastritis identifiable in the antral segment of the stomach. The findings secured can be helpful in the diagnosis of gastritis of different localization, prognostication of the course of the illness, and adoption of adequate therapy.
Duodenal bulb
Gastric antrum
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Acupuncture of points E36 Zusanli and auricular points is shown to influence acid production in the body of the stomach and alkalinization in the stomach antrum in patients with duodenal ulcer and hyperacidity. 20-min acupuncture on points E36 intensifies acid production while 40-min procedure inhibits acid production. Combination of auricular and corporal acupuncture enhances acid production suppression in gastric body and improves alkalinizing function of the antrum.
Zusanli
Gastric antrum
Acupuncture point
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Objective To investigate the effects of small dose of aspirin on gastrointestinal mucosa in the aged.Methods Eighty-two old patients administered with small dose Asplin(50～100 mg·d~(1))were divided into two groups,administration group of below 3 months and group of over 3 months.Gastroscopy and detection of Helicobacter pylori(Hp) were performed in observation group and compared with those in control group(60 cases of health).Results Scores of injury of mucosa in body of stomach,gastric antrum and duodenal bulb in observation group were obviously higher than those in control group(P0.05).Scores of injury of mucosa in body of stomach,gastric antrum and duodenal bulb in group of over 3 months were obviously higher than those in group of below 3 months(P0.05).Scores of injury of mucosa in body of stomach,gastric antrum and duodenal bulb in observation groups of patients with positive and negative Hp were obviously higher than those in control group.(P0.05).Scores of injury of mucosa in body of stomach,gastric antrum and duodenal bulb in observation group of positive Hp were obviously higher than those in group of negative Hp(P0.05).Conclusion Small dose aspirin was damaged to gastrointestinal mucosa in the aged.The longer time of administration and the severe is injury.Injury of gastrointestinal mucosa caused by positive Hp is severe than that caused by negative Hp.
Duodenal bulb
Gastric antrum
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The number of G cells is evaluated in biopsy specimens of fundic, antral and duodenal mucosa from the bulb, second and third parts in 10 patients with duodenal ulcer, and compared with that observed in 6 normal controls. G cells are absent in fundic mucosa but in the antrum their number in duodenal ulcer patients does not differ from that of controls and is strictly related to the histological pattern of the mucosa. In the second and third duodenum of duodenal ulcer patients the number of G cells is significantly higher in comparison with controls, while in the bulb the two groups do not differ significantly. Moreover, when different duodenal portions are compared no differences in the number of G cells are observed in the duodenal ulcer group; while in controls the bulbar number of G cells is higher in comparison with second and third duodenum.
Duodenal bulb
Gastric antrum
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We report a case of lipoma in the antrum of the stomach which prolapsed into the duodenal bulb and caused a duodenal ulcer, which was speculated to have been induced by the friction of its tip against the duodenal mucosa. Although the duodenal ulcer healed after the administration of a proton pump inhibitor, the symptoms of epigastric discomfort continued, which was suggested to be due to the prolapse. Therefore, a laparoscopic operation was conducted. The incidence of lipoma of the stomach is rare, and cases of its prolapse into the duodenum are few. Furthermore, it is extremely rare for it to cause a duodenal ulcer. Because these features made this case clinically interesting, we report it here.
Duodenal bulb
Gastric antrum
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Citations (6)
Background : The aims of this study were to evaluate whether genotypes of Helicobacter pylori are different between the gastric antrum and duodenal bulb in order to assess the roles of duodenal H. pylori strains in development of duodenal ulcer. Methods : Forty-eight H. pylori infected patients (duodenal ulcer 28, chronic gastritis 20) were included for the study. Biopsy specimens were taken separately from the antrum and duodenal bulb for the histologic examination and H. pylori culture. cagA, vacA, and iceA genotypes of H. pylori were examined by polymerase chain reaction and H. pylori DNA subtypes by random amplified polymorphic DNA (RAPD) fingerprinting. Results : H. pylori genotypes were not significantly different between antrum and duodenal bulb of the duodenal ulcer and chronic gastritis. RAPD fingerprinting showed different H. pylori strains between the gastric antrum and duodenal bulb in 2 patients with duodenal ulcer. Most prevalent genotype was cagA+ vacA s1/m1 iceA1 in duodenal ulcer (15/16). Conclusion : The host factor or other genotypes may play the major roles in duodenal ulcerogenesis compared with H. pylori genotype itself.
Duodenal bulb
CagA
Chronic gastritis
Gastric antrum
Duodenal cancer
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Duodenal bulb
Duodenitis
Gastric antrum
Chronic gastritis
Bulb
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The presence of Campylobacter pylori was investigated in biopsies and fluids obtained in the antrum, duodenal bulb and jejunum during jejunoscopy in 20 patients with an active duodenal ulcer. C. pylori was present in cultured antral biopsies in all patients, in the bulb of most patients (16/20), but was unusual in jejunal mucosa (2/20). Using a non-contaminated sampling method of fluid, C. pylori was found in only two samples at each level. In conclusion, C. pylori is frequent in bulbar mucosa of duodenal ulcer patients, rare in jejunal mucosa and in fluid at each level, thus confirming the ecological mucosal niche of C. pylori.
Duodenal bulb
Jejunum
Gastric antrum
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We have compared acidity level and Helicobacter Pylori contamination rate of the mucous coat of stomach in 50 patients with duodenal ulcer at the age from 17 to 54 y.o., among which were 25 smokers and 25 non-smokers. The period of smoking varied from 5 to 21 years. In the morning Ph-measurements were carried out by means of IAS-2 device based on V. N. Chernobrov's method. We used fibrogastroduodenoscopy technique for verifying a duodenal ulcer and obtaining mucous coat material from antrum and corpus ventriculi to obtain Helicobacter Pylori contamination rate. The acid level of the stomach in the smokers was shown to be reliably lower than in non-smoking patients, what was the cause of higher Helicobacter Pylori contamination rate.
Gastric antrum
Helicobacter
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