Abstract
Trench ulcer, a special type of acute gastric ulcer, is complicated in aged patients over 60 years old, suffering from cardiovascular disease such as arteriosclerosis, hypertension or myocardial infarction. To elucidate the pathogenesis of Trench ulcer, serum gastrin, gastric secretion and gastric mucosal blood flow were measured in three cases. Serum gastrin level, gastric acid and pepsin output did not apppear to play an important role in the causation of Trench ulcer. The patient with severe head injury showed low gastric mucosal blood flow prior to the development of Trench ulcer and a transient increase in healing stage. In tetanus patient which had a marked fluctuation of blood preasure, gastric mucosal blood flow during hypotensive period (70/0 mmHg) showed a decrease by 30% compared with that in hypertensive period (200/120 mmHg). Severe hypoxia continued for several hours in the patient with acute carbon monoxide poisoning, although the gastric mucosal blood flow was not decreased after the development of the ulcer. From these results, it seems that the disturbance of gastric mucosal blood supply followed by mucosal hypoxia is a major cause of the development of Trench ulcer.
