The duodenal mucosa in peptic ulcer disease

Summary

The duodenum was evaluated in patients with X-ray negative dyspepsia (6), duodenal ulcer or deformed bulbs (18), duodenitis (3), and normal controls (5), using the peroral small-bowel biopsy instrument of Crosby and Kugler. Specimens from patients with X-ray-negative dyspepsia and normal controls were similar. The majority of patients with duodenal ulcer (14) had normal mucosal biopsies. However, the other 4 patients had marked histological changes, consisting of chronic inflammatory cell infiltration into the submucosa and blunting of the villi. One patient with duodenitis only, demonstrated by X-ray, had pathological findings confirming that diagnosis. No close relationship could be found between pathological material and either clinical or X-ray findings. It is believed that this histological picture is consistent with what has been described pathologically as duodenitis. The significance of these findings awaits further investigation.