Histopathological study of healing process in acute gastritis

Nine patients with hemorrhagic erosion type and 18 patients of ulcerous type of acute gastritis were followed by endoscopy and endoscopic biopsies. Endoscopic findings were as follows: 1) Edema and narrowing of the gastric antrum together with mucosal hemorrhage were present on the first and second days from the onset in both types. 2) On the third day, the erosive area with hemorrhage was demarcated and surrounded by white coating in both types (Figure 1). 3) In the cases of hemorrhagic erosion type, the lesion appeared to heal on the forth and fifth days, however, the dye-spraying method still demonstrated the depression clearly. On the seventh day, the lesion healed completely (Figure 2). 4) In the cases of ulcerous type, the whitish necrotic coating on the ulcer appeared clearly on the third and forth days. The dye-spraying method demonstrated the shallow depression around the ulcer on fifth and sixth days. Histologic findings of the biopsy specimens were as follows: 1) Mucosal necrosis with hemorrhage and hematin was present together with neutro-philic infiltration and hyperemia in the stroma on the first and second days of both types. 2) Regenerative epithelium appeared at the earliest on the first day in both types. On the fifth day, the regenerative epithelium formed foveola-like structure (Figure 7). 3) In the cases of hemorrhagic erosion type, the mucosal necrosis was generally mild with leaving gastric glands on the first and second days. Regeneration occurred rapidly in these cases. 4) In the cases of ulcerous type, the mucosal necrosis was generally marked without leaving gastric glands on the first and second days. Ulceration occurred because of incomplete regeneration in these areas, while rapid regeneration occurred in the areas showing mild mucosal necrosis.