Chronic peptic ulcer – pictures
- Sharply distinct defect (2-4 cm), which destroys mucosa, penetrates the muscularis propria and even to serosa (sign for perforation).
- Gastric glands on the edges of the defect are hypertrophic.
- Bottom of the ulcer is covered with fibrino-purulent exudate.
- Below comes the ‘purple-red’ destructive area of fibrinoid necrosis.
- Below it - plenty of maturing granulation tissue.
- In depth – a sclerotic area (fibrous connective tissue), in which are found vessels with highly thickened walls – endarteriitis-like and endophlebitis-like changes (shown inset)
- Peripheral nerve fibres are also big and hyperthrophic, the so called amputation neuroma.
- Gastric mucosa around the ulcer is with signs of chronic atrophic gastritis.