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Article
November 3, 1934

HETEROTOPIC INTESTINAL MUCOSA AS A POSSIBLE FACTOR IN THE GENESIS OF GASTRIC ULCER

JAMA. 1934;103(18):1380-1381. doi:10.1001/jama.1934.02750440040015
Abstract

The occurrence of heterotopic intestinal mucosa in the mucous membrane of diseased stomachs has been known for some time. It has been found in cases of chronic gastritis, carcinoma, achylia and pernicious anemia. Most observers regard it as an instance of metaplasia arising on a basis of an inflammatory process. This theory found its support in the fact that heterotopic islands of intestinal mucosa occurred with greatest frequency in chronic atrophic gastritis and only rarely in normal stomachs. According to this view, defects in the gastric mucosa resulting from an inflammatory process permit the growth of a new and indifferent epithelium, which may later differentiate into the type resembling intestinal epithelium. The regeneration is therefore of a faulty, atypical kind rather than a true metaplasia. Moszkowitz1 in fact designated it as "indirect metaplasia." This view was shared by Lubarsch, Faber, Heyrovsky and, more recently, by Puhl, Stoerck, Konetzny and

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