Korean J Gastroenterol.  2022 Nov;80(5):225-228. 10.4166/kjg.2022.079.

Collagenous Gastoduodenitis in the Form of a Gastric Ulcer

• Choi IH
• Cho YK
• Park JY
• Kang D
• Park JM
• Choi MG

• KMID: 2536351
• DOI: http://doi.org/10.4166/kjg.2022.079

Abstract

Collagenous gastroduodenitis is a rare gastrointestinal disease diagnosed histologically by subepithelial collagen deposition in the lamina propria. Its clinical presentation is diverse. The authors encountered a 17-year-old female patient who complained of epigastric pain. Endoscopy revealed several deep ulcers in the gastric body. The gastric mucosa around the ulcer showed diffuse fine nodularity in the shape of cobblestones with open-type atrophy. The duodenal mucosa showed nodular lesions similar to those of the gastric mucosa. The gastric ulcer healed completely with proton pump inhibitor treatment. The patient was followed up, showing no remarkable mucosal change of stomach or duodenum for several years. Collagenous gastroduodenitis was diagnosed by repeated histologic examinations. This paper reports a rare case of chronic collagen gastritis with deep gastric ulcer and its long-term clinical progress.

Keyword

Collagen; Gastritis; Ulcer

Figure

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  Fig. 1 Endoscopic images of collagenous gastroduodenitis, showing (A) several deep active ulcers in the stomach, (B) diffuse mucosal nodularity of the gastric body in the shape of cobble stones, (C) normal mucosa around the nodule or atrophy lesion looks like a peninsula, and (D) an open-type atrophy in the stomach. (E) The duodenal mucosa exhibiting nodular lesions similar to those of gastric mucosa. (F) Gastric ulcers were healed after several weeks of treatment with proton pump inhibitors.

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  Fig. 2 Magnifying endoscopic findings with narrow band imaging. (A) The contrast between nodular mucosal lesions and normal mucosa in the form of peninsular is more pronounced in narrow band imaging than in white light endoscopic imaging. (B) Loss of normal capillary networks is observed in the depressed nodular mucosa.

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  Fig. 3 (A, B) The subepithelial layer is thickened by collagen deposition and stained blue with Masson's trichrome stain (×200).

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