Findings

The duodenum and the pyloric region of the stomach is shown in this image. Note the round, sharply demarcated, punched out ulcer in the duodenum (red lesion near the upper left corner of the ruler).

Impression

Duodenum, peptic ulcer

Clinical Pathologic Correlation
Although the pathogenesis of peptic ulcer is not definitively established, exposure to gastric acid and pepsin is thought to be a fundamental predisposing factor. H. pylori infection also seems to play a key role in view of the fact that it is present in virtually all patients with duodenal ulcer, and about 70% of those with gastric ulcer. However, the mechanisms by which it causes ulceration remains to be clarified.

Pathology Pointer

An ulcer in the GI tract is defined as a focal defect in gastrointestinal mucosa that extends through the muscularis mucosa and into the submucosa or deeper layers. More than 95% of ulcers occur either in the first portion of the duodenum or in the stomach with a ratio of about 4:1.

Preparation

Fresh

View

Gross photograph

Specimen

Duodenum

Image Credit

Katsumi M. Miyai, M.D., Ph.D
Department of Pathology
School of Medicine
University of California, San Diego