RESUMEN
To study the ultrastructural findings of gastric antral mucosa and Helicobacter pylori in 10 normal subjects and 30 duodenal ulcer patients before and after treatment. Three antral biopsies were taken from each control and duodenal ulcer patients for a rapid urease test, histopathology and electron microscopic study. All patients underwent a thorough upper gastrointestinal endoscopy before and four weeks after medical treatment of their ulcers. Electron microscopic examination showed a normal gastric mucosa and few numbers Helicobacter pylori in 6 normal controls. However, in duodenal ulcer patients before treatment, electron microscopy showed different patterns of contact between the gastric mucosa and Helicobacter pylori. The more severe damage of epithelial tissue was accompanied by less mucus secretion and a large number of bacteria. Successful eradication of Helicobacter pylori after medical treatment was associated with normalization of gastric mucosa and disappearance of symptoms in 93.3% of our patients. In duodenal ulcer patients, Helicobacter pylori infection was accompanied by destruction of gastric glands, vacuolation of the lining epithelium and atrophic changes of the microvilli. Ulcer healing and eradication of Helicobacter pylori resulted in normalization of the gastric epithelium at the electron microscopic level which we think is more accurate and reliable compared with different diagnostic methods