PECULIARITIES OF ACID PRODUCTION AND PATHOGENESIS OF PYLORIC AND PREPYLORIC GASTRIC ULCER COMPLICATIONS

The purpose of the study was to identify the pathogenesis features of prepiloric and pyloric ulcers and to establish the cause of resistance to conservative therapy and the tendency to complicated course of type III ulcers according to H.D. Johnson. A comparative analysis of acid production was carried out in 150 patents with duodenal ulcer (n-80) and peptic ulcer of type III according to H.D. Johnson classification (n-70). We revealed a definite individual rhythm of daily intragastric acidity with a maximum rise at night in patients with duodenal ulcer. The paper explores the peculiarities of digestive juice secretion depending on ulcerative substratum localization. The pathogenetic validity of the use of antisecretory drugs for duodenal ulcer treatment and the need to further improve the algorithm for pyloric and prepyloric ulcer therapy are shown. For pyloric and prepiloric ulcers characteristic specific morphological changes in the muscle layer of the wall of the antrum, leading to the motor-evacuation disorders and promoting duodenogastric reflux - dystrophy myocytes circular muscle layer vacuolation of the cytoplasm, edema and hypertrophy ganglia intermuscular plexus, hemorrhages in the muscle sheath, violation of muscle bundles.