For undergraduate medical students

1. Gross and Histopathological
findings & complications of
GASTRIC ULCERS
Saleem. Sayed
IInd MBBS
NIMRA INSTITUTE OF MEDICAL SCINCES ,
JUPUDI,VIJAYAWADA.

3. GASTRIC ULCERS

4. Gross findings
1.Number: Single
2.Size: Small in size
3.Shape: Round to oval,
sharply punched-out defect
with non-elevated borders.
4.Base: Smooth & clean.

5. Histopathological findings
• It has 4 histological zones.
• From the surface to the deep layers…..
1.Necrotic zone.
2.Exudative zone.
3.Granulation tissue zone.
4. Zone of cicatrisation (fibrosis).

6. 1. Necrotic zone :
• It lies in the floor of the ulcer.
• Composed of fibrinous exudate
containing necrotic debris and few
WBCs.

7. 2. Exudative zone :
It lies underneath the necrotic zone.
The tissue shows coagulative necrosis
giving
eosinophilic, smudgy nuclear with nuclear
debris.

8. 3. Granulation tissue zone :
It is composed of Mixed inflammatory
infiltrate and many capillaries.

9. 4. Zone of cicatrisation (fibrosis):
It is composed of dense
fibrocollagenic tissue over.

10. COMPLICATIONS
1.Bleeding 2.Perforation 3.Obstruction 4.Malignant transformation

11. COMPLICATIONS
• Bleeding : either from small B.V. erosion (causing nausea, melena, &/or
anemia) or from large B.V. (causing hemorrhage & hematemesis).
• Perforation : leading to peritonitis.
• Obstruction : Ulcers located in the pyloric channel or duodenum may
cause gastric outlet obstruction.
• Malignant transformation : It is very rare.