Abstract
Macroscopic, histopathologic and clinical observations were made on a total of 59 cases of the duodenal ulcer excised in the Clinic of Surgery, Showa Medical School during the 7 years period from April 1953 to March 1960. For histopathological investigation, linear ulcers were discussed separately in view of the difference in their nature from other ulcers which were included under the term “ duodenal ulcer”.
1. Majority of the ulcers examined were round in shape.
2. Most of the linear ulcers were found on the lesser curvature and the duodenal ulcers on the frontal wall.
3. As for the altitude of ulcer formation, both the linear ulcers and the duodenal ulcers were found within 2 cm from the pyloric ring without exception.
4. As for the depth of the ulcers, both the linear ulcers and the duodenal ulcers were of the degree ul-IV.
5. As for the rate of repair, the healing tendency of the ulcers of ul-IV degree was extremely poor in contrast to the degree ul-II and III in either case of the linear ulcer or the duodenal ulcer.
6. As for the interrelationship of the shape, locality and depth, ul-IV degree ulcers were predominant on the lesser curvature, greater curvature and the frontal wall in both the linear ulcer and the duodenal ulcer. Duodenal ulcers were mostly ul-IV degree when they were either round, kissing or flat in shape and they were mostly ul-II degaee when they were irregular, multiple or other degrees.
7. The rate of occurrence between males and females was 58 : 1
8. The age received operation and that of the primary onset were mostly on the twenties and thirties. In most cases, the period of suffering was within 5 years.
9. Epigastric pain was predominant among the main complaints of the primary symptoms and the symptoms during the course of the disease.
10. Gastric juice was either normoacid or hyperacid and fecal occult blood was positive in high percentage.
11. Diagnostic value of X-ray examination is extremely high with high percentage of the detection of nische.
12. As for the relationship of the rate of repair and clinical pictures (ulcerative stage and cicatrizing stage), there was no difference by the difference of epigastric pain, sex or acidity of the gastric juice, but the age of primary onset and operation was younger among the patients of cicatrizing stage. Duration of the clinical course was longer, the rate of the detection of nische or occult blood was lower and the deformity of bulbus was higher on the patients of cicatrizing stage.
13. Round ulcers formed on the frontal wall showed an extremely high rate of perforation, while the ulcers adherent to the pyloric ring were free from this danger.
