Professional Documents
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OF PEPTIC ULCER
Peptic ulcer caused due to high gastrin level and excess acid
production. Gastrinoma may cause multiple peptic ulceration
as in Zollinger Ellison syndrome. There is increased parietal
cell mass.
Depth of penetration :
Superficial ulcer penetrate the mucosa into the
muscularis mucosae.
Deeply excavated ulcers having their bases on the
muscularis propria.
Entire wall is penetrated and the ulcer base is adherant
the base.
Surrounding gastric mucosa:
Puckering of surrounding mucosa. The mucosal fold
Gastric wall:
Scarring involve the entire thickness . Subserosal
fibrosis and inflammation present.
Regional lymphnodes are enlarged.
Biopsy of peptic ulcer:
Healing process-
Regenerating epithelium grows over the over the surface,
(any epithelium growing above an area where muscularis
mucosa is interrupted is regarded as regenerating).
Intestinal metaplasia
May contain chief and parietal cells (ulcer in the fundus
area)
Gastritis remains after ulcer has healed. (D/D In erosive
gastritis & stress ulcer, gastritis in adjacent mucosa is
generally absent)