Current literature is replete with accounts of prolapse of the gastric mucosa through the pylorus as a cause of symptoms; nevertheless, there is still a wide variation of opinion regarding its incidence, etiology, and clinical significance. Rees1 found only 4 cases in 3,000 examinations of the upper gastrointestinal tract; Scott2 observed 14 cases (1.04%) in 1,346 examinations; while Ferguson3 found prolapse of the gastric mucosa in 23 (7.7%) of 297 consecutive patients.
The pathogenesis of this condition is still unknown. The mucosa of the normal stomach is loosely attached to the muscularis and is movable over it. However, at autopsy Scott2 found that this mobility did not permit the mucosa to be drawn through the pylorus into the duodenum. Various explanations for this phenomenon have been advanced. Hypertrophic gastritis,4 developmental anomalies,5 pylorospasm followed by hyperperistalsis,1 failure of the normal "stretching mechanism" of the
Rappaport EM, Rappaport EO, Alper A. INCIDENCE AND CLINICAL SIGNIFICANCE OF TRANSPYLORIC PROLAPSE OF GASTRIC MUCOSA. JAMA. 1952;150(3):182–188. doi:10.1001/jama.1952.03680030014005
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