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A Possible Dual Control Mechanism in the Origin of Peptic Ulcer

1969; Elsevier BV; Volume: 57; Issue: 3 Linguagem: Inglês

10.1016/s0016-5085(19)33901-0

1528-0012

Minoru Oi, Yoji ITO, Fumiya Kumagai, Kan Yoshida, Yoshiki Tanaka, Yoshiki Tanaka, Keiichi Yoshikawa, Otomi Miho, M. Kijima,

Gastrointestinal disorders and treatments

In study I, 855 peptic ulcers were found in a group of 640 gastric specimens obtained surgically. The locations of these ulcers were observed in their relation to mucosae. It was found that nearly all ulcers were located adjacent to a mucosal boundary and, moreover, the ulcers were located on the side of the boundary opposite the fundic gland area. In study II, 269 ulcers were found in another group of 211 gastric specimens similarly obtained surgically. The locations of these ulcers were observed in their relation to musculature. It was found that nearly all ulcers were located within identifiable special muscular areas. In study III, by means of transparent cellophane overlays, the locations of the 269 ulcers of study II were observed in their relation to both musculature and mucosae. It was found that the locations of nearly all ulcers were seemingly affected or controlled by both mucosal boundaries and muscle bundles. This dual effect or influence of both the mucosae and musculature has been designated “dual control mechanism.” Finally, by means of the concept of dual control mechanism an attempt speculatively has been made to explain the significance of the local pathogenic factor of peptic ulceration, a possible reason for the chronicity and single development of peptic ulcers, and the reason why gastric ulcers frequently appear at the gastric angulus of the lesser curvature of the stomach.