As treatment progresses, the ulcer enters the healing phase, characterized by the gradual reduction of the slough and the appearance of regenerative tissue.
This is the initial phase when the ulcer is actively inflamed and causing the most severe symptoms for the patient. The division between A1 and A2 reflects the earliest signs of the body's healing efforts.
The for moving between stages (e.g., A1 to H1).
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The system is divided into three primary stages, each containing two sub-levels based on the visual appearance of the ulcer during an endoscopy: 1. The Active Stage (A) A1 (Active-1):
This transition indicates that medical treatment or natural recovery is effectively closing the wound.
The following table summarizes the endoscopic appearance at each stage. As treatment progresses, the ulcer enters the healing
: The regenerating epithelium completely covers the ulcer floor, and the white coating has disappeared. The area appears markedly red due to many visible capillaries. S2 (White Scar)
The active stage signifies an ongoing, open mucosal defect that has not yet begun significant re-epithelialization.
is the hallmark of an acute, active ulcer. The ulcer crater is typically deep and completely covered by a thick, shaggy layer of white or yellowish-white fibrin slough—the necrotic tissue at the base of the ulcer. This stage is characterized by significant inflammation of the surrounding area; the mucosa adjacent to the crater is markedly swollen, red, and edematous, which makes the ulcer’s margins look heaped up. Importantly, no visible regenerating epithelium (the new, healthy pink tissue) is seen at the edges. The for moving between stages (e
The ulcer is deep, with a white, necrotic base and sharp, well-defined margins. There is often edema (swelling) surrounding the edge of the ulcer.
The system divides childhood TB into two primary groups: