Morphological changes of the mucous membranes of gastroduodenal system

Structural changes of the mucous membrane of stomach and duodenal ulcers are different at different locations ulcers: in the body of the stomach or piloroduodenalnoy area.
When duodenal ulcer thickness of the mucous membrane of the stomach is increased, is hyperplasia tuck, main and mukodni (extension) of cells (Stempien, 1964). Given the development in such cases, gastric hypersecretion, Stempien proposes to call this form of defeat mucous membrane "hypertrophic hypersecretory the gastropathy". In recent years through targeted aspiration biopsy under x-ray control have been confirmed previously obtained data to the high frequency of focal antral gastritis in patients with peptic ulcer. N. Century Smirnova (1971), Schrager and others (1967) offer to call them "intitemi". Among the operated patients antral gastritis was found in 100% of patients with duodenal ulcer (Magnus, 1952).
B. N. Salupere (1969) with the localization of ulcers on the bioptic material found that gastritises changes in the body of the stomach occurred in 16%, and in the antrum - 65% of the patients.
In the General opinion, stomach ulcers in most cases (60 - 80%) combined with chronic gastritis in the body of the stomach (C. So Gidecek, 1967; A. F. of Pleskava, 1967; B. N. Salupere, 1969). Even more common antral gastritis, frequency of which, according to B. N. Salupere reaches 94%.
Fundic gastritis accompanied by sharp reduction of gastric secretion. Antral gastritis, on the one hand, may violate the physiological mechanism of inhibition of allocation of hydrochloric acid, which, obviously, has the value with duodenal ulcer. On the other hand, atrophic changes in the antrum can Deplete the body of gastrin and thereby contribute to the trophic disorders in the body of the stomach. It is essential that the incidence of chronic gastritis and severity of structural changes depend on the duration and severity of the disease.
Recently in a series of works (C. M. Zolotov, 1964; C., Masevich and C. M. Zolotov, 1965; T. N. Sadkova, 1966; T. N. Sadkova and C. M. Zolotov, 1967) using the method of aspiration biopsy of the mucosa of the duodenum (sampling was obtained from the section of intestine outside ulcers), it was established that in patients with duodenal ulcer often duodenitis, from the surface to the atrophic. Stomach ulcers, duodenitis occurred much less frequently. However, Cheli (1968) found only a focal inflammatory changes in the mucosa of the duodenum near ulcers, which he does not make pathogenetic significance.
Morphological changes in the duodenum may violate physiological depressant mechanism in respect of gastric secretion. A. A. Uman (1960) suggested that it affects chemoreceptors mucosa that no longer respond to changes in pH. In addition, the development of chronic duodenitis reduces the protective capabilities of the mucous membrane and facilitates the implementation of the pathological effects of acid-peptic factor.
Thus, morphological changes of the mucous membranes of gastroduodenal systems have an important role in the pathogenesis of peptic ulcer disease. They create the bridgehead, which actively act other pathological factors ulcerogenesis.