A STUDY ON THE STRUCTURE OF LAYERS OF THE GASTROINTESTINAL WALL VISUALIZED BY MEANS OF THE ULTRASONIC ENDOSCOPE 1) THE STRUCTURE OF LAYERS OF THE GASTRIC WALL

Abstract

The author reported that 5 layers, 9 layers and 11 layers of the gastric wall could be visualized by means of the ultrasonic endoscope and clarified these layers of the gastric wall by comparing endoscopic ultrasonograms with corresponding histology. The results were as follows; 1) In 5 layers of the gastric wall, the 1st layer and the 2nd layer meant the mucosal layer, the 3rd layer was the submucosal layer and the 4th layer corresponded to the muscular layer. 2) The 1st layer was a border echo visualized inside the mucosal layer. The 5th layer consisted of the serosal layer and a border echo demonstrated outside the serosal layer. 3) The gastric wall was separated to 9 layers when a thin layer was visualized at the same time in the 2nd layer and the 4th layer. The gastric wall was demonstrated as 11 layers when a thin layer was visualized in the 2nd layer and two thin layers were seen in the 4th layer. 4) The muscular membrane was composed of a thin layer in the 2nd layer and a norrow layer between a thin layer in the 2nd layer and the 3rd layer. A thin layer in the 2nd layer was a border echo visualized inside the muscular membrane. 5) A thin layer in the 4th layer of the gastric wall consisted of a border echo and a connective tissue between the inner circular muscle and the outer longitudinal muscle. Two thin layers in the 4th layer of the gastric wall were thought to be composed of border echos and each connective tissues between the inner oblique muscle and the middle circular muscle and between the middle circular muscle and the outer longitudinal muscle. 6) The proper echo of the muscular membrane was thought to be hypoechoic. The proper echos of the lamina propria and the gastric glands were hypoechoic. 7) The gastric mucus was visualized as a high echo, but had no relation to the 1st layer of the gasric wall.