십이지장 (十二指腸) 질환의 내시경적 (內視鏡的) 소견과 임상적 (臨床的) 고찰 = Clinical Observation of Endoscopic Diagnosis of Duodenum십이지장 (十二指腸) 질환의 내시경적 (內視鏡的) 소견과 임상적 (臨床的) 고찰

다국어 초록 (Multilingual Abstract)

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다국어 초록 (Multilingual Abstract)

The duodenum located at the center of the abdomen, is apparently the most important site for digestion, anatomically, physiologically and in chemical basis and so more abundant and advanced study would be needed. 1, 006 patients with endoscopicallv diagnosed duodenal diseases from 1973 to 1981, were analyzed in various view in this study. The results were as follows; I. The incidence of duodenal ulcer and duodenitis was 6.5% and 8.1% each of total endoscoped patients. 2. Male to female ratio in duodenal ulcer was 4. 3: 1, whereas the ratio in duodenitis was 1.2: 1; The occurrence ratio was highest among thirties in both diseases. 3. The most common type of ducdenal ulcer was round(65.2%), medium sized(63.4%) one that is located at the side of greater curvature(52.8%) within ducdenal bulb. 4. Duodenitis consisted Of nonspecific duodenitis (70. 4%), erosive duodenitis (27. 6%) and hemorrhagic duodenitis(2.0%). 5. In total 274 cases having a concomitant upper gastrointestinal X-ray study, endoscopic and x-ray diagnosis agreed in 69.6% of 136 cases with endoscopically proven duodenal ulcer, wheras only 9.6% of 138 cases with endoscopically proven duodenitis revealed the same result of X-ray. From these points, it is suggested that the initial diagnosis of duodenitis, decision of ulcer activity and detection of bleeding focus would have to be made by endoscopic examination. In bleeding conditions from duodenal pathology, melena to hematemesis ratio was l. 2:1 in duodenal ulcer and 1: 1. 2 in duodenitis. 7. Stormach conditions in 443 ducdenal ulcers were normal(44.6%), gastric ulccr(19.6%), acute erosive gastritis(16.7%) and chronic superficial gastritis(15.8%) in order of frequency.; It is suggested that duodenal ulcer might be related to normal or hyperchlorhydric state of stomach. 8. Stomach conditions associatcd with duodenitis were chronic superficial gastritis(44.2,%), acute erosive gastritis(23.8%), and gastric ulcer(15.3%) in order of frequency, whereas normal stomach states were only 9. 4%. From these findings, it is suggested that duodenitis would be a secondary change reflecting pathology of stomach or other neighboring organs. 9. Other main diseases associated with duodenal pathology were hepatopathy, hypertension, colitis, and chronic obstructive pulmonary diseases in order of frequency. 10. Patients with blood type 0 were 38.1% in duodenal ulcer group and 32.5% in duoden it is, comparing with 29. 0% in generat population in Korea. Ll. Smoker to non-smoker ratio was 1.7: 1 in duodenal ulcer and 1: 2. 7 in ducdenitis; epidemiological study of alcohol, coffee and taste did not show any diffence between duodenal ulcer and duodenitis . More detail study is necessary to know relationship between duodenitis and duodenal ulcer and pathogenesis of duodenitis secondary to pathologic conditions of neighbor organ or gastro intestinal hormones,