Double pylorus (DP) or duplication of the pylorus is an uncommon condition that is either congenital or acquired. Acquired double pylorus (DP) results from a peptic ulcer eroding through and creating a fistula between the duodenal bulb and the distal stomach. We report a case of an acquired double pylorus in an adult gentleman that resulted from the erosion of a duodenal and prepyloric ulcer.
Duodenal Ulcer/*pathology ; Pylorus/*pathology ; Stomach Ulcer/*pathology

The pathological changes of the gastric rumen produced by rocking stress in 38 young male albino rats fed on low protein diet for a short period and in 20 young male albino rats fed on low protein diet only as the control rats, were investigated macroscopically and histologically. The ulcerative lesions of the gastric rumen were observed in 17 out of 38 experimental rats accompanied with hyperplasia and cornification of the ruminal epithelial layer and more or less edematous changes of the tunica propria near the ulcer site. The authors, finding of the ruminal ulcer in albino rats produced by rocking stress associated with feeding on a low protein diet for a short period were compared with the results of others. The authors discussed other opinions concerning of the gastric ruminal ulcer of the albino rats produced in various ways.
Animal ; Male ; Protein Deficiency/complications* ; Rats ; Rumen* ; Stomach Ulcer/etiology* ; Stomach Ulcer/pathology ; Stress*

PURPOSE: The aim of the present study was to assess the clinical, endoscopic and histologic findings of the Helicobacter pylori(Hp)-associated gastritis in children. METHODS: We have assessed 91 patient(age range 3-15 years) referred for upper intestinal endoscopy during 17 months. At least two antral biopsies were taken during endoscopy. The histological analysis and CLO test were done. The histologic changes were scored and semiquantitative assessment of the degree of Hp colonization was performed using Giemsa' stain. RESULTS: 1) Helicobacter pylori(Hp) was detected by CLO test and/or histologic analysis in 35 patients(38.5%). The CLO test was positive in 25 cases and H. pylori was colonized histologically in 10 patients. 2) The clinical symptoms were not significantly different between Hp positive and Hp negative patients(p>0.01). 3) Nodular antritis(37.1%) was a frequent endoscopic finding in Hp-infected patients, particularly in the subgroup with active chronic gastritis(93.8%). All patient with nodular antritis had Hp infection. 4) Helicobacter pylori has been associated both with active chronic gastritis(42.9%) and with nonactive chronic gastritis(40.0%). The common abnormal histologic finding was active chronic gastritis(42.9%) in Hp positive patients and nonactive chronic gastritis(66%) in HP negative patients. A significant correlation was found between Hp colonization score and the histologic categories(p<0.01). 5) The frequency of Hp infection(positiveness) as related to histologic categories was: active chronic gastritis 93.8 %; duodenal ulcer 66.7%; gastric ulcer 33.3 %; nonactive chronic gastritis 27.5%; normal 16.7%. 6) The histolgical colonization by Hp was assessed semiquantitatively, and a significantly greater Hp colonization score was observed in patients with signs of histological activity(p<0.01). CONCLUSIONS: This study suggests that Hp infection was significantly associated with endoscopic nodular antritis and the presence of gastroduodenal pathology.
Biopsy ; Child* ; Colon ; Duodenal Ulcer ; Endoscopy ; Gastritis* ; Helicobacter pylori ; Helicobacter* ; Humans ; Pathology ; Stomach Ulcer

OBJECTIVES: Clinical presentation of Helicobacter pylori (H. pylori) infection has marked variation mainly due to the strain diversity and host susceptibility. Although H. pylori is identified as a major risk factor for gastric and duodenal ulcers, the ulcerogenic or pathogenic strain has not been documented yet. The objective of this study was to investigate antigenic types of the ulcerogenic strain of H. pylori. METHODS: The sera of 64 patients were tested by Western blot using Helicoblot 2.0 for six major anti-H. pylori antibodies, together with CLO test and histological examination of gastric biopsy tissues. Thirty-five, nine and 20 patients had duodenal ulcer, gastric ulcer and chronic active gastritis, respectively. The antigenic types of H. pylori were analyzed in 54 patients with positive H. pylori infection. In this study, H. pylori was divided into four serotypes according to the presence and absence of CagA and VagA: type I; CagA (+) and VacA(+), type Ia: CagA (+) and VacA(-), type Ib: CagA(-) and VacA(+), and type II: CagA(-) and VacA(-). RESULTS: There was no difference in the number of bands for six antigens: 3.2 +/- 1.4, 3.0 +/- 1.2 and 3.1 +/- 1.4 in 35 duodenal ulcer, 7 gastric ulcer and 12 chronic gastritis, respectively. The band with 119 kDa was 90.7%, which was the most common band with the order of 35, 30, 26.5, 89 and 19.5 kDa. Type I, la and Ib were positive in 22.2, 42.6 and 27.8%, respectively, which were significantly higher than type II (p < 0.05). There was no difference in the positive rates of four urease subtypes between the four serotypes.
Adult ; Aged ; Antigens, Bacterial/classification* ; Antigens, Bacterial/analysis ; Blotting, Western ; Chronic Disease ; Comparative Study ; Duodenal Ulcer/pathology ; Duodenal Ulcer/microbiology* ; Duodenal Ulcer/immunology ; Gastric Mucosa/pathology ; Gastric Mucosa/microbiology ; Gastritis/pathology ; Gastritis/microbiology ; Gastritis/immunology ; Helicobacter Infections/immunology* ; Helicobacter pylori/immunology* ; Human ; Middle Age ; Serotyping ; Stomach Ulcer/pathology ; Stomach Ulcer/microbiology* ; Stomach Ulcer/immunology ; Substances: Antigens, Bacterial

A gastropericardial fistula, defined as penetration of a gastric lesion into the pericardium, is a rare occurrence. Such a fistula is usually associated with a huge ulcer in the gastric fundus, an ulcer within a hiatus hernia, a history of esophagogastric surgery, the concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs), or Zollinger-Ellison syndrome. The patient in this case presented with shoulder pain and melena, caused by a gastropericardial fistula that had occurred as a late complication of postoperative esophagogastrostomy and a refractory gastric ulcer. Despite the severity of the condition, the patient showed great improvement after medical treatment and the fistula was cured at the end.
Esophagectomy/*methods ; Gastric Fistula/*diagnosis/*etiology ; Humans ; Male ; Middle Aged ; Pericardium/*pathology ; Stomach Ulcer/*complications/*surgery

Inflammatory fibroid polyp is a relatively rare, benign polyp which is composed of fibraus connective tissue, blood vessels, and infiltration of eosinophils. The majority of inflammatory fibroid polyps has been reported with pathologic specimen in stomach and small intestine. We performed the gastrofiberscopy and endoscopic ultrasonogram of an inflammatory fibroid polyp, which reveals central ulcerated polypoid mass originated in the submucosa of antral portion of the stomach. So we report a case of endoscopic and endoscopic ultrasonographic findings of inflammatory fibroid piolyp in stomach. The etiolagy and pathology are discussed with the review of the literatures.
Blood Vessels ; Connective Tissue ; Eosinophils ; Intestine, Small ; Leiomyoma* ; Pathology ; Polyps* ; Stomach* ; Ulcer ; Ultrasonography

Possible lymph node metastasis (LNM) and residual cancer are major concerns in endoscopic submucosal dissection (ESD) for early gastric cancer. To reduce the risk of LNM and cancer recurrence, the proper indications for ESD should be considered. Histology, size, depth of invasion, and presence of ulceration should be thoroughly evaluated before proceeding with ESD. However, with incomplete information, discrepancies often arise between the pathological diagnosis based on the forceps biopsy and that based on the totally resected specimen. In addition, the presence of lymphovascular involvement and histological homogeneity can be clarified only after ESD. If the pathological diagnosis changes after ESD, we should reevaluate the curativeness and reformulate the goal of treatment. Additional surgery is a reasonable strategy for non-curative ESD, but a patient's other health conditions should also be considered. It is simple to read pathological reports before and after ESD, but it can be a complicated art to interpret the report and formulate an optimal approach. In this review, various considerations regarding the pathological diagnosis will be discussed.
Biopsy ; Diagnosis ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm, Residual ; Pathology ; Recurrence ; Stomach Neoplasms* ; Surgical Instruments ; Ulcer

BACKGROUND AND OBJECTIVES: Tonsillar tissue is a component of mucosa-associated lymphoid tissue (MALT), which has evolved to protect vulnerable mucosal surfaces. Helicobacter pylori, implicated as an etiological factor in duodenal ulcer and gastritis, induces the appearance of lymphoid aggregates in the stomach. Therefore, we investigate the possibility that tonsils can be extragastric reservoir and target tissue for H. pylori. SUBJECTS AND METHOD: Campylobacter-Like Organism (CLO) test and immunohistochemical (IHC) analysis for H. pylori was performed on 98 patients undergoing tonsillectomy. Chronic tonsillitis group (62 patients) and controlled group (36 patients) were enrolled in this study. Tissue samples were collected from excised palatine tonsils. Two millimeter diameter tissue piece that had been obtained from palatine tonsil specimens were placed in the CLO test kit. Remnant tonsils were sent to the Department of Pathology for IHC analysis. RESULTS: Using the CLO test, H. pylori was detected in 60 (61.2%) of the 98 patients, 39 (62.9%) of 62 in chronic tonsillitis group and 21 (58.3%) of 36 in control group. Using the IHC analysis, it was detected in 54 (55.1%) of the 98 patients, 35 (56.5%) of 62 in chronic tonsillitis group and 19 (52.8%) of 36 in control group. There are no significant differences between chronic tonsillitis group and control group with regard to both CLO & IHC analysis. CONCLUSION: This result suggests that palatine tonsil represents an extragastric reservoir for H. pylori infection, but not a target tissue.
Duodenal Ulcer ; Gastritis ; Helicobacter pylori* ; Helicobacter* ; Humans ; Lymphoid Tissue ; Palatine Tonsil* ; Pathology ; Stomach ; Tonsillectomy ; Tonsillitis*

PURPOSE: To evaluate the usefulness of CT for assessing the location and cause of pathologic gastrointestinal perforation. MATERIALS AND METHODS: A retrospective analysis of abdominal CT was performed in 27 perforations of 26 patients with underlying gastrointestinal pathology. Fifteen benign and 12 malignant perforations consisted of five gastric cancers, one gastric ulcer, ten duodenal bulb ulcers, two bowel adhesions, one jejunal metastasis from lung cancer, one ileocolic Crohn's disease, one radiation colitis and six colon cancers. CT scans were evaluated for 1) diagnosis of bowel perforation, 2) assessment of the cause and site of perforation, and, in particular, differentiation between benignancy and malignancy, and 3) complications and their extent. RESULTS: CT easily detected varying amounts of free air or fluid collection, and infiltration or abscess formation adjacent to the main lesion, and the diagnosis of gastrointestinal perforation was therefore easy. In 11 of the 12 malignancies (92%), primary tumor was diagnosed, but detection of the site of perforation was possible in only seven cases (7/12, 58%). The 15 benign lesions revealed nonspecific CT findings, and the perforation site could be presumed in six (6/15, 40%). In one case of Crohn's disease, the primary cause was visualized. Among six colonic cancers, four pericolic abscesses and two fistulas to adjacent organs were found, but there was no evidence of diffuse peritonitis. CONCLUSION: CT was helpful to lead to optimal treatment of pathologic gastrointestinal On CT, the detectability of perforation, primary benign or malignant lesion, perforation site and extent of complication was high, and this modality was therefore a useful indicator of the optimal treatment for pathologic gastrointestinal perforations.
Abscess ; Colitis ; Colonic Neoplasms ; Crohn Disease ; Diagnosis ; Fistula ; Humans ; Lung Neoplasms ; Neoplasm Metastasis ; Pathology ; Peritonitis ; Pneumoperitoneum ; Retrospective Studies ; Stomach Neoplasms ; Stomach Ulcer ; Tomography, X-Ray Computed ; Ulcer

Biopsy ; Dissection ; Gastric Mucosa ; pathology ; surgery ; Gastroscopy ; methods ; Humans ; Neoplasm Invasiveness ; Neoplasm Staging ; Neoplastic Cells, Circulating ; Stomach Neoplasms ; pathology ; surgery ; Stomach Ulcer ; pathology