Endoscopic signs of duodenal erosion

Erosion is a shallow limited superficial defect of the mucous membrane, reaching its own plate and not penetrating to the muscular plate of the mucosa. The form is linear or round. The borders, unlike ulcers, are vague. In addition, erosion can be raised with biopsy forceps together with the surrounding mucous membrane, while the ulcer base is tightly fixed. Healing erosions occur within a few hours or days without the formation of a scar.

Endoscopic characteristics of erosions and ulcers

	Erosion	Ulcer
Damage	Defect within the mucosa	The defect can capture the entire wall
The form	Round or linear	Round, linear or incorrect
Value	Small: only a few millimeters	Usually larger than a few millimeters
Depth	Defect flat (slightly submerged)	The defect is deep, it can penetrate all the layers of the wall
Amount	Usually multiple	As a rule, single
The basis of the defect	Blood, hematin or fibrinous exudate	Blood, clots, hematin, fibrin, pus or necrotic masses
The edges	Flat, often vague	Clearly delimited, smoothed or raised, solid or intermittent
Mobility	Mobile with mucous membrane	Has a fixed base
Flow	As a rule, acute (chronic erosions are called papules)	Usually subacute or chronic
Healing	Through reepitelization (without scar)	Through scar formation

According to the etiology, 3 groups of erosions are distinguished:

1. Idiopathic erosion with a tendency to periodic exacerbation.
2. Erosions arising from a stressful situation.
3. Erosions arising from the use of drugs and alcohol.

Classification.

1. Hemorrhagic erosion.
2. Incomplete erosion.
3. Full erosion.

Hemorrhagic erosion. These are multiple small-dot defects of the mucosa up to 0.1 cm in diameter dark-cherry color. Can be nested, forming spots. There is no inflammation of the mucosa around. They can cause profuse bleeding. Relate to acute erosion, exist from a few hours to 10 days. Localized in the bulb and the initial part of postbulbarnyh departments, rarely - only in postbulbarnyh departments.

Incomplete erosion. Have a rounded shape, smooth edges. Dimensions of 0.2-0.4 cm in diameter. The bottom is often clean, but can be covered with a thin coating of whitish fibrin. Around the erosion there is a corolla of hyperemia. Usually, erosions are multiple, located locally, in connection with which the affected areas have a peculiar kind of "pepper with salt" (by the definition of Japanese authors) because of the contrasting mosaic combination of white and bright red flowers. Fusing, erosion can form large erosive surfaces of irregular shape. When the erosion heals, the plaque disappears, the surface becomes pink. In acute and subacute course epithelialized within 5-10 days (may be epithelialized for several hours).

Full erosion. They are rare. Localize only in the bulb. Polypoid formations of a hemispherical shape with a slight depression at the apex or without it. In the period of exacerbation, a thin fibrin plaque appears on the apex. During the period of remission, it disappears. Dimensions 0.3-0.5 cm at the base. These erosions are chronic and can last for years.

[1], [2], [3], [4], [5], [6], [7], [8], [9]