Incidence of Gastric Metaplasia and Helicobacter pylori Infection in Duodenal Bulb – With Specific Reference to Patients With Duodenal Ulcers

摘要

We determined the incidence of gastric metaplasia in the duodenal bulb of duodenal ulcerpatients and the Helicobacter pylori (H. pylori) infection rate at sites with gastric metaplasia. Biopsy of the duodenal bulb showed the presence of gastric metaplasia in 61 of 86 patients(71%) overall and in 18 of 47 patients (38.3%) who had gastrectomy at an early gastriccancer. The histological diagnosis of H. pylori infection showed good agreement (83.3%)with the result of the rapid urease test, indicating that H. pylori occurs in regions with gastricmetaplasia. This finding suggests that H. pylori infects gastric metaplasia in the duodenalbulb, causing mucosal injury, which is then transformed into duodenal ulcers. The exactmechanism by which gastric metaplasia is caused is unknown, but it is believed to occur inthe transitional zone in the duodenal mucosa.