IPLab:Lab 3:Chronic Peptic Ulcer - Revision history

Peter Anderson: /* Images */

2020-06-20T00:09:18Z

Images

← Older revision		Revision as of 19:09, 19 June 2020
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	File:IPLab3ChronicPepticUlcer1b.jpg\|This is a gross photograph of a stomach containing two ulcers. Note the gastric mucosa that extends up to the edge of the ulcer (arrows).		File:IPLab3ChronicPepticUlcer1b.jpg\|This is a gross photograph of a stomach containing two ulcers. Note the gastric mucosa that extends up to the edge of the ulcer (arrows).
	File:IPLab3ChronicPepticUlcer2.jpg\|This is a gross photograph of the ulcer after it has been transected. The edge of the mucosa (1) is better appreciated in this image. Note the thick, fatty tissue (2) which makes up the base of this ulcer (3).		File:IPLab3ChronicPepticUlcer2.jpg\|This is a gross photograph of the ulcer after it has been transected. The edge of the mucosa (1) is better appreciated in this image. Note the thick, fatty tissue (2) which makes up the base of this ulcer (3).
	File:IPLab3ChronicPepticUlcer3b.~~jpg~~\|This is a low-power photomicrograph of a section through the transected ulcer. The blue cells on the right hand side of this section are the normal gastric epithelial cells of the mucosa (1). Note the absence of any epithelial cells within the crater of the ulcer (2).		File:IPLab3ChronicPepticUlcer3b.JPG\|This is a low-power photomicrograph of a section through the transected ulcer. The blue cells on the right hand side of this section are the normal gastric epithelial cells of the mucosa (1). Note the absence of any epithelial cells within the crater of the ulcer (2).
	File:IPLab3ChronicPepticUlcer4b.~~jpg~~\|This is a photomicrograph of the margin of the ulcer. Note the intact epithelium on the right side of the section (1) and the ulcerated region without epithelium on the left (2). There are numerous inflammatory cells within this tissue.		File:IPLab3ChronicPepticUlcer4b.JPG\|This is a photomicrograph of the margin of the ulcer. Note the intact epithelium on the right side of the section (1) and the ulcerated region without epithelium on the left (2). There are numerous inflammatory cells within this tissue.
	File:IPLab3ChronicPepticUlcer5b.~~jpg~~\|This is a medium-power photomicrograph of the base of the ulcer with the fibrinopurulent membrane (1) overlying the ulcerated surface. The ulcerated surface contains granulation tissue and inflammatory cells (2).		File:IPLab3ChronicPepticUlcer5b.JPG\|This is a medium-power photomicrograph of the base of the ulcer with the fibrinopurulent membrane (1) overlying the ulcerated surface. The ulcerated surface contains granulation tissue and inflammatory cells (2).
	File:IPLab3ChronicPepticUlcer6b.~~jpg~~\|This high-power photomicrograph of the ulcer base (arrows) demonstrates the lack of epithelium and the exuberant inflammatory response (1) consisting of primarily of fibrin and neutrophils (PMNs). The surface of the ulcer bed is covered with this fibrinopurulent exudate.		File:IPLab3ChronicPepticUlcer6b.JPG\|This high-power photomicrograph of the ulcer base (arrows) demonstrates the lack of epithelium and the exuberant inflammatory response (1) consisting of primarily of fibrin and neutrophils (PMNs). The surface of the ulcer bed is covered with this fibrinopurulent exudate.
	File:IPLab3ChronicPepticUlcer7b.~~jpg~~\|This high-power photomicrograph of the ulcer base demonstrates plump, activated fibroblasts and endothelial cells (arrows) within the granulation tissue that makes up the base of the ulcer. There are inflammatory cells (primarily lymphocytes) within this region as well.		File:IPLab3ChronicPepticUlcer7b.JPG\|This high-power photomicrograph of the ulcer base demonstrates plump, activated fibroblasts and endothelial cells (arrows) within the granulation tissue that makes up the base of the ulcer. There are inflammatory cells (primarily lymphocytes) within this region as well.
	File:IPLab3ChronicPepticUlcer8b.~~jpg~~\|This low-power photomicrograph demonstrates the healing reaction in the base of this ulcer. The base of the ulcer is at the top of the image and the serosal surface is at the bottom. Note the granulation tissue and fibrous connective tissue within the wall of the stomach (1) and the layer of inflammatory exudate on the surface of the ulcer (arrow).		File:IPLab3ChronicPepticUlcer8b.JPG\|This low-power photomicrograph demonstrates the healing reaction in the base of this ulcer. The base of the ulcer is at the top of the image and the serosal surface is at the bottom. Note the granulation tissue and fibrous connective tissue within the wall of the stomach (1) and the layer of inflammatory exudate on the surface of the ulcer (arrow).
	</gallery>		</gallery>

Peter Anderson: /* Images */

2020-06-20T00:03:03Z

Images

← Older revision		Revision as of 19:03, 19 June 2020
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	== Images ==		== Images ==
	<gallery heights="250px" widths="250px">		<gallery heights="250px" widths="250px">
	File:~~IPLab3ChronicPepticUlcer1~~.jpg\|This is a gross photograph of a stomach containing ~~an ulcer~~. Note the ~~folded pink~~ gastric mucosa that extends up to the edge of the ulcer (arrows).		File:IPLab3ChronicPepticUlcer1b.jpg\|This is a gross photograph of a stomach containing two ulcers. Note the gastric mucosa that extends up to the edge of the ulcer (arrows).
	File:IPLab3ChronicPepticUlcer2.jpg\|This is a gross photograph of the ulcer after it has been transected. The edge of the mucosa (1) is better appreciated in this image. Note the thick, fatty tissue (2) which makes up the base of this ulcer (3).		File:IPLab3ChronicPepticUlcer2.jpg\|This is a gross photograph of the ulcer after it has been transected. The edge of the mucosa (1) is better appreciated in this image. Note the thick, fatty tissue (2) which makes up the base of this ulcer (3).
	File:~~IPLab3ChronicPepticUlcer3~~.jpg\|This is a low-power photomicrograph of the transected ulcer. The blue cells on the right hand side of this section are the normal gastric epithelial cells of the mucosa (1). Note the absence of any epithelial cells within the crater of the ulcer (2).		File:IPLab3ChronicPepticUlcer3b.jpg\|This is a low-power photomicrograph of a section through the transected ulcer. The blue cells on the right hand side of this section are the normal gastric epithelial cells of the mucosa (1). Note the absence of any epithelial cells within the crater of the ulcer (2).
	File:~~IPLab3ChronicPepticUlcer4~~.jpg\|This is a photomicrograph of the margin of the ulcer. Note the intact epithelium on the right side of the section (1) and the ulcerated region without epithelium on the left (2). There are numerous inflammatory cells within this tissue.		File:IPLab3ChronicPepticUlcer4b.jpg\|This is a photomicrograph of the margin of the ulcer. Note the intact epithelium on the right side of the section (1) and the ulcerated region without epithelium on the left (2). There are numerous inflammatory cells within this tissue.
	File:~~IPLab3ChronicPepticUlcer5~~.jpg\|This is a medium-power photomicrograph of the base of the ulcer with the fibrinopurulent membrane (1) overlying the ulcerated surface. The ulcerated surface contains granulation tissue and inflammatory cells (2).		File:IPLab3ChronicPepticUlcer5b.jpg\|This is a medium-power photomicrograph of the base of the ulcer with the fibrinopurulent membrane (1) overlying the ulcerated surface. The ulcerated surface contains granulation tissue and inflammatory cells (2).
	File:~~IPLab3ChronicPepticUlcer6~~.jpg\|This high-power photomicrograph of the ulcer base (arrows) demonstrates the lack of epithelium and the exuberant inflammatory response (1) consisting of primarily of fibrin (~~and adherent gastric secretions~~) ~~and PMNs~~. The surface of the ulcer bed is covered with this fibrinopurulent exudate.		File:IPLab3ChronicPepticUlcer6b.jpg\|This high-power photomicrograph of the ulcer base (arrows) demonstrates the lack of epithelium and the exuberant inflammatory response (1) consisting of primarily of fibrin and neutrophils (PMNs). The surface of the ulcer bed is covered with this fibrinopurulent exudate.
	File:~~IPLab3ChronicPepticUlcer7~~.jpg\|This high-power photomicrograph of the ulcer base demonstrates plump, activated fibroblasts and endothelial cells (arrows) within the granulation tissue that makes up the base of the ulcer. There are inflammatory cells (primarily lymphocytes) within this region as well.		File:IPLab3ChronicPepticUlcer7b.jpg\|This high-power photomicrograph of the ulcer base demonstrates plump, activated fibroblasts and endothelial cells (arrows) within the granulation tissue that makes up the base of the ulcer. There are inflammatory cells (primarily lymphocytes) within this region as well.
	File:~~IPLab3ChronicPepticUlcer8~~.jpg\|This low-power photomicrograph demonstrates the healing reaction in the base of this ulcer. The base of the ulcer is at the ~~left-hand side~~ of the image and the serosal surface is at the ~~right~~. Note the fibrous connective tissue within the wall of the stomach and the layer of inflammatory exudate on the surface of the ulcer (arrow).		File:IPLab3ChronicPepticUlcer8b.jpg\|This low-power photomicrograph demonstrates the healing reaction in the base of this ulcer. The base of the ulcer is at the top of the image and the serosal surface is at the bottom. Note the granulation tissue and fibrous connective tissue within the wall of the stomach (1) and the layer of inflammatory exudate on the surface of the ulcer (arrow).
	~~File:IPLab3ChronicPepticUlcer9.jpg\|This high-power photomicrograph demonstrates the granulation tissue within the base of the ulcer.~~
	~~File:IPLab3ChronicPepticUlcer10.jpg\|This is a photomicrograph of the serosal surface (1) from a section of stomach near the ulcer. Note that the inflammatory reaction extends out to the serosa.~~
	File:IPLab3ChronicPepticUlcer11.jpg\|This is a trichrome-stained section of tissue demonstrating fibrous connective tissue scar formation (blue color) in this lesion. The surface of the ulcer is at the left-hand side of the image. There is a layer of inflammatory cells and RBCs on the surface of the ulcer.
	</gallery>		</gallery>

Peter Anderson: /* Clinical Summary */

2020-06-19T23:56:53Z

Clinical Summary

← Older revision		Revision as of 18:56, 19 June 2020
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	== Clinical Summary ==		== Clinical Summary ==
	~~This~~ 56-year-old white female was admitted to the hospital with ~~a six-year history of~~ epigastric pain and burning. This pain was said to be worse at night and on an empty stomach~~. The patient reported that the pain was relieved by drinking milk~~. She had also experienced several episodes of hematemesis and melena ~~since the onset of the pain, the last episode occurring 3 weeks prior to admission~~. ~~The patient described intermittent episodes of colicky pain~~ in the ~~right upper quadrant and right side of the abdomen, frequently radiating to the back and shoulders and often accompanied by "bilious vomiting~~.~~" Physical examination~~ was ~~noncontributory except for tenderness in~~ the ~~epigastrium~~ and ~~right upper quadrant~~. ~~An upper GI series showed changes suggestive of~~ a ~~neoplasm. The~~ patient ~~submitted to an abdominal exploration at which time a partial gastrectomy was performed~~.		A 56-year-old white female was admitted to the hospital with severe epigastric pain and burning. This pain, which has occurred intermittently for the Last 4 years was said to be worse at night and on an empty stomach. She had also experienced several episodes of hematemesis and melena. An upper endoscopy was performed which demonstrated an ulcer in the gastric mucosa. A breath test for Helicobacter pylori was positive so the patient was started on antibiotics and proton pump inhibitors (PPI).

			Autopsy pictures and histology sections from a different patient with peptic ulcer disease are presented.

	== Images ==		== Images ==

Peter Anderson: /* Journal Articles */

2016-08-25T14:09:36Z

Journal Articles

← Older revision		Revision as of 09:09, 25 August 2016
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	=== Journal Articles ===		=== Journal Articles ===
	* ~~Mackie DB, Gent AE~~. [http://www.~~ncbi~~.~~nlm.nih.gov~~/~~pmc~~/~~articles~~/~~PMC2491545/ Management of upper gastrointestinal haemorrhage~~]. ''~~Ann R Coll Surg Engl~~'' ~~1977 January~~; ~~59(1)~~: ~~56–60~~.		* Laine L. [http://www.nejm.org/doi/10.1056/NEJMcp1514257 Upper Gastrointestinal Bleeding Due to a Peptic Ulcer.] ''NEJM'' 2016 June 22; 374: 2367-2376.

	=== Images ===		=== Images ===

Seung Park at 16:08, 3 January 2014

2014-01-03T16:08:12Z

← Older revision		Revision as of 11:08, 3 January 2014
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	File:IPLab3ChronicPepticUlcer11.jpg\|This is a trichrome-stained section of tissue demonstrating fibrous connective tissue scar formation (blue color) in this lesion. The surface of the ulcer is at the left-hand side of the image. There is a layer of inflammatory cells and RBCs on the surface of the ulcer.		File:IPLab3ChronicPepticUlcer11.jpg\|This is a trichrome-stained section of tissue demonstrating fibrous connective tissue scar formation (blue color) in this lesion. The surface of the ulcer is at the left-hand side of the image. There is a layer of inflammatory cells and RBCs on the surface of the ulcer.
	</gallery>		</gallery>

			== Virtual Microscopy ==
			<peir-vm>IPLab3ChronicPepticUlcer</peir-vm>

	== Study Questions ==		== Study Questions ==

Seung Park: /* Images */

2013-08-30T01:27:05Z

Images

← Older revision		Revision as of 20:27, 29 August 2013
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	=== Images ===		=== Images ===
	* [~~http://peir.path.uab.edu~~/library/index.php?/tags/122-peptic_ulcer PEIR Digital Library: Peptic Ulcer Images]		* [{{SERVER}}/library/index.php?/tags/122-peptic_ulcer PEIR Digital Library: Peptic Ulcer Images]
	* [http://library.med.utah.edu/WebPath/GIHTML/GIIDX.html#2 WebPath: Stomach Pathology]		* [http://library.med.utah.edu/WebPath/GIHTML/GIIDX.html#2 WebPath: Stomach Pathology]

Seung Park: /* Additional Resources */

2013-08-21T22:22:43Z

Additional Resources

← Older revision		Revision as of 17:22, 21 August 2013
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	* [http://peir.path.uab.edu/library/index.php?/tags/122-peptic_ulcer PEIR Digital Library: Peptic Ulcer Images]		* [http://peir.path.uab.edu/library/index.php?/tags/122-peptic_ulcer PEIR Digital Library: Peptic Ulcer Images]
	* [http://library.med.utah.edu/WebPath/GIHTML/GIIDX.html#2 WebPath: Stomach Pathology]		* [http://library.med.utah.edu/WebPath/GIHTML/GIIDX.html#2 WebPath: Stomach Pathology]

	~~=== Related IPLab Cases ===~~


	{{IPLab 3}}		{{IPLab 3}}

	[[Category: IPLab:Lab 3]]		[[Category: IPLab:Lab 3]]

Seung Park: /* Images */

2013-08-21T22:22:29Z

Images

← Older revision		Revision as of 17:22, 21 August 2013
Line 31:		Line 31:

	=== Images ===		=== Images ===
			* [http://peir.path.uab.edu/library/index.php?/tags/122-peptic_ulcer PEIR Digital Library: Peptic Ulcer Images]
			* [http://library.med.utah.edu/WebPath/GIHTML/GIIDX.html#2 WebPath: Stomach Pathology]

	=== Related IPLab Cases ===		=== Related IPLab Cases ===

Seung Park: /* Journal Articles */

2013-08-21T22:20:50Z

Journal Articles

← Older revision		Revision as of 17:20, 21 August 2013
Line 28:		Line 28:

	=== Journal Articles ===		=== Journal Articles ===
			* Mackie DB, Gent AE. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2491545/ Management of upper gastrointestinal haemorrhage]. ''Ann R Coll Surg Engl'' 1977 January; 59(1): 56–60.

	=== Images ===		=== Images ===

Seung Park: /* Reference */

2013-08-21T22:19:23Z

Reference

← Older revision		Revision as of 17:19, 21 August 2013
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	== Additional Resources ==		== Additional Resources ==
	=== Reference ===		=== Reference ===
			* [http://emedicine.medscape.com/article/181753-overview eMedicine Medical Library: Peptic Ulcer Disease]
			* [http://www.merckmanuals.com/professional/gastrointestinal_disorders/gastritis_and_peptic_ulcer_disease/gastritis.html Merck Manual: Gastritis and Peptic Ulcer Disease]

	=== Journal Articles ===		=== Journal Articles ===

← Older revision		Revision as of 19:09, 19 June 2020
Line 8:		Line 8:
	File:IPLab3ChronicPepticUlcer1b.jpg\|This is a gross photograph of a stomach containing two ulcers. Note the gastric mucosa that extends up to the edge of the ulcer (arrows).		File:IPLab3ChronicPepticUlcer1b.jpg\|This is a gross photograph of a stomach containing two ulcers. Note the gastric mucosa that extends up to the edge of the ulcer (arrows).
	File:IPLab3ChronicPepticUlcer2.jpg\|This is a gross photograph of the ulcer after it has been transected. The edge of the mucosa (1) is better appreciated in this image. Note the thick, fatty tissue (2) which makes up the base of this ulcer (3).		File:IPLab3ChronicPepticUlcer2.jpg\|This is a gross photograph of the ulcer after it has been transected. The edge of the mucosa (1) is better appreciated in this image. Note the thick, fatty tissue (2) which makes up the base of this ulcer (3).
	File:IPLab3ChronicPepticUlcer3b.~~jpg~~\|This is a low-power photomicrograph of a section through the transected ulcer. The blue cells on the right hand side of this section are the normal gastric epithelial cells of the mucosa (1). Note the absence of any epithelial cells within the crater of the ulcer (2).		File:IPLab3ChronicPepticUlcer3b.JPG\|This is a low-power photomicrograph of a section through the transected ulcer. The blue cells on the right hand side of this section are the normal gastric epithelial cells of the mucosa (1). Note the absence of any epithelial cells within the crater of the ulcer (2).
	File:IPLab3ChronicPepticUlcer4b.~~jpg~~\|This is a photomicrograph of the margin of the ulcer. Note the intact epithelium on the right side of the section (1) and the ulcerated region without epithelium on the left (2). There are numerous inflammatory cells within this tissue.		File:IPLab3ChronicPepticUlcer4b.JPG\|This is a photomicrograph of the margin of the ulcer. Note the intact epithelium on the right side of the section (1) and the ulcerated region without epithelium on the left (2). There are numerous inflammatory cells within this tissue.
	File:IPLab3ChronicPepticUlcer5b.~~jpg~~\|This is a medium-power photomicrograph of the base of the ulcer with the fibrinopurulent membrane (1) overlying the ulcerated surface. The ulcerated surface contains granulation tissue and inflammatory cells (2).		File:IPLab3ChronicPepticUlcer5b.JPG\|This is a medium-power photomicrograph of the base of the ulcer with the fibrinopurulent membrane (1) overlying the ulcerated surface. The ulcerated surface contains granulation tissue and inflammatory cells (2).
	File:IPLab3ChronicPepticUlcer6b.~~jpg~~\|This high-power photomicrograph of the ulcer base (arrows) demonstrates the lack of epithelium and the exuberant inflammatory response (1) consisting of primarily of fibrin and neutrophils (PMNs). The surface of the ulcer bed is covered with this fibrinopurulent exudate.		File:IPLab3ChronicPepticUlcer6b.JPG\|This high-power photomicrograph of the ulcer base (arrows) demonstrates the lack of epithelium and the exuberant inflammatory response (1) consisting of primarily of fibrin and neutrophils (PMNs). The surface of the ulcer bed is covered with this fibrinopurulent exudate.
	File:IPLab3ChronicPepticUlcer7b.~~jpg~~\|This high-power photomicrograph of the ulcer base demonstrates plump, activated fibroblasts and endothelial cells (arrows) within the granulation tissue that makes up the base of the ulcer. There are inflammatory cells (primarily lymphocytes) within this region as well.		File:IPLab3ChronicPepticUlcer7b.JPG\|This high-power photomicrograph of the ulcer base demonstrates plump, activated fibroblasts and endothelial cells (arrows) within the granulation tissue that makes up the base of the ulcer. There are inflammatory cells (primarily lymphocytes) within this region as well.
	File:IPLab3ChronicPepticUlcer8b.~~jpg~~\|This low-power photomicrograph demonstrates the healing reaction in the base of this ulcer. The base of the ulcer is at the top of the image and the serosal surface is at the bottom. Note the granulation tissue and fibrous connective tissue within the wall of the stomach (1) and the layer of inflammatory exudate on the surface of the ulcer (arrow).		File:IPLab3ChronicPepticUlcer8b.JPG\|This low-power photomicrograph demonstrates the healing reaction in the base of this ulcer. The base of the ulcer is at the top of the image and the serosal surface is at the bottom. Note the granulation tissue and fibrous connective tissue within the wall of the stomach (1) and the layer of inflammatory exudate on the surface of the ulcer (arrow).
	</gallery>		</gallery>

← Older revision		Revision as of 19:03, 19 June 2020
Line 6:		Line 6:
	== Images ==		== Images ==
	<gallery heights="250px" widths="250px">		<gallery heights="250px" widths="250px">
	File:~~IPLab3ChronicPepticUlcer1~~.jpg\|This is a gross photograph of a stomach containing ~~an ulcer~~. Note the ~~folded pink~~ gastric mucosa that extends up to the edge of the ulcer (arrows).		File:IPLab3ChronicPepticUlcer1b.jpg\|This is a gross photograph of a stomach containing two ulcers. Note the gastric mucosa that extends up to the edge of the ulcer (arrows).
	File:IPLab3ChronicPepticUlcer2.jpg\|This is a gross photograph of the ulcer after it has been transected. The edge of the mucosa (1) is better appreciated in this image. Note the thick, fatty tissue (2) which makes up the base of this ulcer (3).		File:IPLab3ChronicPepticUlcer2.jpg\|This is a gross photograph of the ulcer after it has been transected. The edge of the mucosa (1) is better appreciated in this image. Note the thick, fatty tissue (2) which makes up the base of this ulcer (3).
	File:~~IPLab3ChronicPepticUlcer3~~.jpg\|This is a low-power photomicrograph of the transected ulcer. The blue cells on the right hand side of this section are the normal gastric epithelial cells of the mucosa (1). Note the absence of any epithelial cells within the crater of the ulcer (2).		File:IPLab3ChronicPepticUlcer3b.jpg\|This is a low-power photomicrograph of a section through the transected ulcer. The blue cells on the right hand side of this section are the normal gastric epithelial cells of the mucosa (1). Note the absence of any epithelial cells within the crater of the ulcer (2).
	File:~~IPLab3ChronicPepticUlcer4~~.jpg\|This is a photomicrograph of the margin of the ulcer. Note the intact epithelium on the right side of the section (1) and the ulcerated region without epithelium on the left (2). There are numerous inflammatory cells within this tissue.		File:IPLab3ChronicPepticUlcer4b.jpg\|This is a photomicrograph of the margin of the ulcer. Note the intact epithelium on the right side of the section (1) and the ulcerated region without epithelium on the left (2). There are numerous inflammatory cells within this tissue.
	File:~~IPLab3ChronicPepticUlcer5~~.jpg\|This is a medium-power photomicrograph of the base of the ulcer with the fibrinopurulent membrane (1) overlying the ulcerated surface. The ulcerated surface contains granulation tissue and inflammatory cells (2).		File:IPLab3ChronicPepticUlcer5b.jpg\|This is a medium-power photomicrograph of the base of the ulcer with the fibrinopurulent membrane (1) overlying the ulcerated surface. The ulcerated surface contains granulation tissue and inflammatory cells (2).
	File:~~IPLab3ChronicPepticUlcer6~~.jpg\|This high-power photomicrograph of the ulcer base (arrows) demonstrates the lack of epithelium and the exuberant inflammatory response (1) consisting of primarily of fibrin (~~and adherent gastric secretions~~) ~~and PMNs~~. The surface of the ulcer bed is covered with this fibrinopurulent exudate.		File:IPLab3ChronicPepticUlcer6b.jpg\|This high-power photomicrograph of the ulcer base (arrows) demonstrates the lack of epithelium and the exuberant inflammatory response (1) consisting of primarily of fibrin and neutrophils (PMNs). The surface of the ulcer bed is covered with this fibrinopurulent exudate.
	File:~~IPLab3ChronicPepticUlcer7~~.jpg\|This high-power photomicrograph of the ulcer base demonstrates plump, activated fibroblasts and endothelial cells (arrows) within the granulation tissue that makes up the base of the ulcer. There are inflammatory cells (primarily lymphocytes) within this region as well.		File:IPLab3ChronicPepticUlcer7b.jpg\|This high-power photomicrograph of the ulcer base demonstrates plump, activated fibroblasts and endothelial cells (arrows) within the granulation tissue that makes up the base of the ulcer. There are inflammatory cells (primarily lymphocytes) within this region as well.
	File:~~IPLab3ChronicPepticUlcer8~~.jpg\|This low-power photomicrograph demonstrates the healing reaction in the base of this ulcer. The base of the ulcer is at the ~~left-hand side~~ of the image and the serosal surface is at the ~~right~~. Note the fibrous connective tissue within the wall of the stomach and the layer of inflammatory exudate on the surface of the ulcer (arrow).		File:IPLab3ChronicPepticUlcer8b.jpg\|This low-power photomicrograph demonstrates the healing reaction in the base of this ulcer. The base of the ulcer is at the top of the image and the serosal surface is at the bottom. Note the granulation tissue and fibrous connective tissue within the wall of the stomach (1) and the layer of inflammatory exudate on the surface of the ulcer (arrow).
	~~File:IPLab3ChronicPepticUlcer9.jpg\|This high-power photomicrograph demonstrates the granulation tissue within the base of the ulcer.~~
	~~File:IPLab3ChronicPepticUlcer10.jpg\|This is a photomicrograph of the serosal surface (1) from a section of stomach near the ulcer. Note that the inflammatory reaction extends out to the serosa.~~
	File:IPLab3ChronicPepticUlcer11.jpg\|This is a trichrome-stained section of tissue demonstrating fibrous connective tissue scar formation (blue color) in this lesion. The surface of the ulcer is at the left-hand side of the image. There is a layer of inflammatory cells and RBCs on the surface of the ulcer.
	</gallery>		</gallery>