The healing of a primaryduodenal ulcer with the later development of a gastric ulcer

Abstract

In a study of 500 cases of peptic ulcer, a combined gastric and duodenal ulcer was found in 21 cases or 4.2 percent. Among the 21 cases of combined peptic ulcers, there were 6 instances or 1.2 percent of the entire series or 28.5 percent of the combined ulcers, in which it was clinically and roentgenologically demonstrated that one of the ulcers had been healed completely and the other had remained active. The site of the original ulcération was in the duodenum, and the second ulcer occurred in the stomach. Attention is drawn to the fact that one must not always assume that when there is a recurrence of symptoms it is due to a recurrence of the same ulcer at the original site. It is further emphasized that when a patient is found to have a peptic ulcer which has shown roentgen and clincial evidence of complete healing and the patient has been asymptomatic for an indeterminate period of time, the recurrence of digestive symptoms may indicate the formation of a new ulcer at a different site. A clinical example of the latter type of case is described.