GASTROSCOPIC OBSERVATIONS IN PERNICIOUS ANEMIA

Abstract

The close relation between pernicious anemia and changes in the mucosa of the stomach has been well recognized since the time of Austin Flint¹ and Hayem.² A brilliant synopsis of all the questions involved has been given by Minot.³ Friedenwald and Morrison⁴ stated as early as 1919 that practically no patient with pernicious anemia is free from gastrointestinal symptoms. Anatomically there was early general agreement (Faber and Bloch⁵) that the gastric mucosa was thinned or degenerated, that these changes were most pronounced in the cardiac region and that they diminished toward the pylorus. In later times this anatomic concept changed. Cases were described in which the wall of the pyloric region was tremendously thickened by inflammation of the deeper layers, especially of the muscularis propria (Kleemann⁶), and even by the formation of inflammatory polyps—gastritis hypertrophicans polyposa—in the pyloric region (Mayeda⁷). In 1934 M. R. Brown,⁸ in a report on