ULCER OF THE STOMACH. 



373 



wall near the pylorus (Fig. 164). In size it varies from one- 

 quarter of an inch to four or five inches in diameter; generally, 

 however, from a half to two inches. In shape it is usually 

 rounded or oval, and has a characteristic punched-out appear- 

 ance, especially if the mucous membrane alone is involved. 

 If it is deeper, the excavation may be somewhat funnel-shaped 

 by reason of its sloping edges. 



FIG. 166. 



An ulcer of the stomach, showing at its base the open orifice of a vessel: death 

 from hemorrhage (Warren Museum). 



If all the coats of the stomach-wall are involved, as often 

 happens, inflammatory adhesions may bind it to an adjacent 

 organ, as the liver or pancreas, which thus comes to form the 

 floor of the ulcer. 



Microscopically, there is noted some round-celled infiltration 

 in the immediate neighborhood of the ulcer. The walls of 

 the adjacent bloodvessels are greatly thickened by an obliter- 



