ENDOSCOPICAL FOLLOW-UP STUDY OF BENIGN ESOPHAGEAL ULCERS

Abstract

During the past fourteen years, we have experienced 52 cases of benign esophageal ulcer among 1403 cases of routine esophageal endoscopic examination. The following results were obtained : 1) These were frequently found in male, and the peak age ranged 60 to 69 years. 2) Clinically, heart burn was the most frequent symptom. In some cases we found hematemesis and melena. 3) Among the 52 cases, 18 were cases with chronic intractable esophageal ulcers endoscopically followed up over 6 months. Hiatal hernia was observed in all the 18 cases and the degree of hiatal hernia tended to well correlate with the severity of diseases. 4) Histopathologically, Barrett's ulcer and dysplasia were observed in some followed up cases, but no malignant change was observed. 5) Thirty-eight out of the 52 cases, especially almost all cases with chronic ulcers had certain associated diseases. Progressive systemic sclerosis and liver diseases were seen in high incidence. Diabetes mellitus, cholelithiasis, coronary insufficiency and bronchial diseases were also frequently encountered in patients with esophageal ulcer. 6) The findings that analysis of gastric juice did not show increased acidity in these chronic cases, and that the drugs which have antisecretory effect of gastric acid output were not so effective suggest the possibility that the disturbance of microcirculation or motor function resulting in the decreased defense mechanism of esophageal mucosa caused by the associated diseases may also play a role in the pathophysiology of esophageal ulcer.