Abstract
Using total 240 surgically resected gastric specimens, a study on a relationship between the anatomical characteristics of gastro-duodenal junction and the locations of duodenal ucler was undertaken.1) Muscular aspects of duodenal uclers revealed that all uclers of duodenum were located on or close to the pyloric ring.2) Ratios of the thickness of the pyloric circular muscle and dudoenal circular muscle to the pyloric circular muscle bundle were measured. Pyloric circular muscle bundle (P.C.M.B.) is particularly thick and about 2.6 times thicker than pyloric circular muscle at 2 cm and 1 cm proximal to the P.C.M.B. and about 6.6 times thicker than duodenal circular muscle.This anatomical characteristics of gastroduodenal junction suggest a probable existence of “strain zone” of gastro-duodenal peristalsis between distal antrum and proximal duodenum. However, gastric specimens without duodenal ulcer also revealed the some anatomical characteristics.3) Longitudinal muscle of stomach is usually continuous to that of duodenum in the majority of the specimens. However, there were some cases with partial interruption of the continuity of the longitudinal muscles. Another anatomical characteristic of this part is an existence of adventitial septum between the pyloric ring and duodenal circular muscle that showed occasional partial deficit at any part of the circle. Those anatomical characteristics showed no particular relationship to the occurrence of the ulcer.4) On mucosal aspects, the pyloro-duodenal glands borders were found to be located close to the pyloric ring and on the duodenal side in majority of the cases. All of the duodenal ulcers were located close to the mucosal border and on the duodenal side.The anatomical relationships between the pyloric ring and the mucosal border were classified in the IV types but thise typings revealed no particular relationship to the occurrence of the ulcer.
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