Background: The relationship between superficial findings and the inner structure of gastric ulcers is unclear. The present study was undertaken to clarify the relationship between them.
Methods: In the first study, 43 patients with active gastric ulcers were examined by endoscopic ultrasonography (EUS) in each stage of Sakita's endoscopic classification. In the second study, 16 patients with gastric ulcer scars were examined by EUS in both S1 stage and S2 stage.
Results: Ulcer area, ulcer length, thickness of the ulcer base, and diameter of the crater differed significantly in each endoscopic stage. Ulcer area, ulcer length, and thickness of the ulcer base differed significantly even between S1 stage and S2 stage. Mean ulcer area in S1 stage was 96.9 mm2; this shows that the ulcer scar in S1 stage is incomplete with regard to tissue contraction. Although ulcer area in S2 stage had shrunk significantly compared with that in S1 stage, it still remained 53.3 mm2. This implies that the risk of local recurrence remains even in S2 stage.
Conclusions: Sequential observation by EUS showed that the healing of the ulcer surface strongly reflected the healing within the ulcers.