Abstract
We have experienced 8 cases with peptic ulcer showing protruding changes in their healing processes. Seven cases are gastric ulcer and the other is duodenal ulcer. On consecutive endoscopic examinations, in the early phase of these lesions, ulcer floors were observed to become elevated and finally to make protruding lesions (Figure 3). In their healing stage, these protrusion had diminished in height and red scars were observed at the regions. Biopsied specimens showed these lesions were consisted of granulation tissues and were different from 'elevated type gastric ulcer scar'. These lesions were observed in stomach body, angle, antrum and duodenal bulb, suggesting that there are no specific regions for these lesions to occur. These protruded lesions were appeared in 2 to 5 weeks after the active stage of the ulcer and disappeared within 5 weeks to 12 months (Figure 6, 7). Incidence of this lesion is 1.2 % in gastric ulcer and 0.8% in duodenal ulcer in our hospital. All cases reported here had been treated with histamine H2 receptor antagonists, cimetidine or famotidine. Because of the powerful antacid effect of these drugs, we speculate that the healing process of the ulcer could be accelated, and that these putative rapid healing might account for the transient appearance of 'over-healing' granulation lesions. We think that this lesion is considered as a special type of healing in peptic ulcer.
