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典型的急性胃炎,胃黏膜广泛充血。急性胃炎的原因很多有:酒精中毒,药物,感染,等。

This is a more typical acute gastritis with a diffusely hyperemic gastric mucosa. There are many causes for acute gastritis: alcoholism, drugs, infections, etc.

大面积胃出血,最好用术语“腐蚀”表示,是由于表面黏膜腐蚀脱落引起的。病理过程术语为胃病, 描述胃黏膜损害并不伴有明显的炎症。图示急性侵蚀性胃炎,当然也有其它类型。各种胃病的病因包括:酒精,药物,例如NSAIDS(非类固醇类抗炎药),应激,尿毒症,胆汁逆流,门脉高压症,放射线,和化疗。

Here are some larger areas of gastric hemorrhage that could best be termed "erosions" because the superficial mucosa is eroded away. Such erosions are typical for the pathologic process termed gastropathy, which describes gastric mucosal injury without significant inflammation. The findings here fit with acute erosive gastropathy, but there are other patterns. Etiologies for the various gastropathies can include: alcohol, drugs such as NSAIDS, stress, uremia, bile reflux, portal hypertension, radiation, and chemotherapy.

图示急性胃炎,高倍镜胃黏膜表现有中性粒细胞的浸润。

At high power, gastric mucosa demonstrates infiltration by neutrophils. This is acute gastritis.

胃底部1厘米的急性胃溃疡。溃疡表浅、边界清晰,周围有充血。图示能是良性溃疡。胃溃疡应该作活检排除恶性。

A 1 cm acute gastric ulcer is shown here in the upper fundus. The ulcer is shallow and sharply demarcated, with surrounding hyperemia. It is probably benign. However, all gastric ulcers should be biopsied to rule out a malignancy.

急性幽门前区胃溃疡的内窥镜检查如图。

The endoscopic appearance of a similar acute peptic ulcer in the prepyloric region is seen below.

胃镜小溃疡。所有的胃溃疡都作了活组织检查,因为仅肉眼检查不能决定是否是恶性。小的有明显分界的溃疡很可能是良性的。

All gastric ulcers are biopsied, since gross inspection alone cannot determine whether a malignancy is present. Smaller, more sharply demarcated ulcers are more likely to be benign.

胃镜中等大小溃疡。
胃镜大溃疡。

胃切除标本,3 x 4厘米大的胃溃疡。溃疡较深,边缘不规则。胃溃疡的并发症(良性或者恶性)有疼痛,出血,穿孔和梗阻。

Here is a much larger 3 x 4 cm gastric ulcer that led to the resection of the stomach shown here. This ulcer is much deeper with more irregular margins. Complications of gastric ulcers (either benign or malignant) include pain, bleeding, perforation, and obstruction.

显微镜下,溃疡边界清楚,左边正常的胃黏膜脱落形成一个深的溃疡,其基底部有炎症和坏死碎片。溃疡底部动脉分支被侵蚀出血。

Microscopically, the ulcer here is sharply demarcated, with normal gastric mucosa on the left falling away into a deep ulcer whose base contains infamed, necrotic debris. An arterial branch at the ulcer base is eroded and bleeding.


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