eMedicine Specialties > Radiology > Gastrointestinal

Duodenum, Ulcers: Multimedia

Author: Isaac Hassan, MB, ChB, FRCR, DMRD, Former Senior Consultant Radiologist, Department of Radiology, St Bernard's Hospital, Gibraltar
Contributor Information and Disclosures

Updated: Mar 5, 2009

Multimedia

Double-contrast upper gastrointestinal series. Po...Media file 1: Double-contrast upper gastrointestinal series. Posterior wall duodenal ulcer.
Double-contrast upper gastrointestinal series. Po...

Double-contrast upper gastrointestinal series. Posterior wall duodenal ulcer.

Same patient as in <a href="#MULTIMEDIA">Image 1 ...Media file 2: Same patient as in Image 1 in Multimedia. Lateral view of a posterior wall ulcer.
Same patient as in <a href="#MULTIMEDIA">Image 1 ...

Same patient as in Image 1 in Multimedia. Lateral view of a posterior wall ulcer.

Double-contrast upper gastrointestinal series. An...Media file 3: Double-contrast upper gastrointestinal series. Anterior wall ulcer in a duodenal cap.
Double-contrast upper gastrointestinal series. An...

Double-contrast upper gastrointestinal series. Anterior wall ulcer in a duodenal cap.

Same patient as in <a href="#MULTIMEDIA">Image 3 ...Media file 4: Same patient as in Image 3 in Multimedia. Lateral view of an anterior wall duodenal ulcer.
Same patient as in <a href="#MULTIMEDIA">Image 3 ...

Same patient as in Image 3 in Multimedia. Lateral view of an anterior wall duodenal ulcer.

Duodenal cap ulcer in a patient with a short hist...Media file 5: Duodenal cap ulcer in a patient with a short history of symptoms.
Duodenal cap ulcer in a patient with a short hist...

Duodenal cap ulcer in a patient with a short history of symptoms.

Deformity of duodenal cap caused by recurrent ulc...Media file 6: Deformity of duodenal cap caused by recurrent ulceration. Single-contrast view.
Deformity of duodenal cap caused by recurrent ulc...

Deformity of duodenal cap caused by recurrent ulceration. Single-contrast view.

Same patient as in <a href="#MULTIMEDIA">Image 6 ...Media file 7: Same patient as in Image 6 in Multimedia. Double-contrast view.
Same patient as in <a href="#MULTIMEDIA">Image 6 ...

Same patient as in Image 6 in Multimedia. Double-contrast view.

Postbulbar ulcer.Media file 8: Postbulbar ulcer.
Postbulbar ulcer.

Postbulbar ulcer.

Same patient as in <a href="#MULTIMEDIA">Image 8 ...Media file 9: Same patient as in Image 8 in Multimedia. Single-contrast view.
Same patient as in <a href="#MULTIMEDIA">Image 8 ...

Same patient as in Image 8 in Multimedia. Single-contrast view.

Gastric outlet obstruction caused by deformed duo...Media file 10: Gastric outlet obstruction caused by deformed duodenal cap from recurrent peptic ulceration.
Gastric outlet obstruction caused by deformed duo...

Gastric outlet obstruction caused by deformed duodenal cap from recurrent peptic ulceration.

Large volume of residual gastric juice in gastric...Media file 11: Large volume of residual gastric juice in gastric outlet obstruction. Note the fluid level (arrow) between the barium and gastric juice. Nasogastric aspiration before radiographic examination aids assessment of these cases.
Large volume of residual gastric juice in gastric...

Large volume of residual gastric juice in gastric outlet obstruction. Note the fluid level (arrow) between the barium and gastric juice. Nasogastric aspiration before radiographic examination aids assessment of these cases.

Obstruction as a result of marked narrowing of th...Media file 12: Obstruction as a result of marked narrowing of the first and second parts of the duodenum. Laparotomy demonstrated malignant infiltration of the duodenum caused by adenocarcinoma of the gallbladder.
Obstruction as a result of marked narrowing of th...

Obstruction as a result of marked narrowing of the first and second parts of the duodenum. Laparotomy demonstrated malignant infiltration of the duodenum caused by adenocarcinoma of the gallbladder.

Upper gastrointestinal series. Annular shouldered...Media file 13: Upper gastrointestinal series. Annular shouldered stricture caused by carcinoma in the second part of the duodenum.
Upper gastrointestinal series. Annular shouldered...

Upper gastrointestinal series. Annular shouldered stricture caused by carcinoma in the second part of the duodenum.

Large 2-cm adenoma in the descending part of the ...Media file 14: Large 2-cm adenoma in the descending part of the duodenum.
Large 2-cm adenoma in the descending part of the ...

Large 2-cm adenoma in the descending part of the duodenum.

Chest radiograph. Free gas under the diaphragm ca...Media file 15: Chest radiograph. Free gas under the diaphragm caused by a perforated duodenal ulcer.
Chest radiograph. Free gas under the diaphragm ca...

Chest radiograph. Free gas under the diaphragm caused by a perforated duodenal ulcer.

A gas-fluid level is seen under the right diaphra...Media file 16: A gas-fluid level is seen under the right diaphragm as a result of a subphrenic collection caused by a perforated duodenal ulcer.
A gas-fluid level is seen under the right diaphra...

A gas-fluid level is seen under the right diaphragm as a result of a subphrenic collection caused by a perforated duodenal ulcer.

This computed tomography scan shows a large, righ...Media file 17: This computed tomography scan shows a large, right subphrenic collection.
This computed tomography scan shows a large, righ...

This computed tomography scan shows a large, right subphrenic collection.

More on Duodenum, Ulcers

Overview: Duodenum, Ulcers
Imaging: Duodenum, Ulcers
Follow-up: Duodenum, Ulcers
Multimedia: Duodenum, Ulcers
References
Further Reading

References

  1. Levine MS. Peptic ulcers. In: Gore RM, Levine MS, eds. Textbook of Gastrointestinal Radiology. 2nd ed. Philadelphia, Pa: WB Saunders;. 2000: 514-45.

  2. Newton EB, Versland MR, Sepe TE. Giant duodenal ulcers. World J Gastroenterol. Aug 28 2008;14(32):4995-9. [Medline].

  3. Ramakrishnan K, Salinas RC. Peptic ulcer disease. Am Fam Physician. Oct 1 2007;76(7):1005-12. [Medline].

  4. Pattison CP, Combs MJ, Marshall BJ, et al. Helicobacter pylori and peptic ulcer disease: evolution to revolution to resolution. AJR Am J Roentgenol. Jun 1997;168(6):1415-20. [Medline][Full Text].

  5. Peek RM Jr, Blaser MJ. Pathophysiology of Helicobacter pylori-induced gastritis and peptic ulcer disease. Am J Med. Feb 1997;102(2):200-7. [Medline].

  6. Suerbaum S, Michetti P. Helicobacter pylori infection. N Engl J Med. Oct 10 2002;347(15):1175-86. [Medline].

  7. Lanas A, Serrano P, Bajador E, et al. Evidence of aspirin use in both upper and lower gastrointestinal perforation. Gastroenterology. Mar 1997;112(3):683-9. [Medline].

  8. Love JW. Peptic ulceration may be a hormonal deficiency disease. Med Hypotheses. 2008;70(6):1103-7. [Medline].

  9. Levine MS, Kelly MR, Laufer I, et al. Gastrocolic fistulas: the increasing role of aspirin. Radiology. May 1993;187(2):359-61. [Medline].

  10. Horton KM, Fishman EK. MDCT and 3-dimensional computed tomography imaging of small bowel neoplasms: current concept in diagnosis. J Comput Assist Tomogr. Jan-Feb 2004;28(1):106-16.

  11. Husain S, Ahmed AR, Johnson J, Boss T, O'Malley W. CT scan diagnosis of bleeding peptic ulcer after gastric bypass. Obes Surg. Nov 2007;17(11):1520-2. [Medline].

  12. Ghekiere O, Lesnik A, Hoa D, Laffargue G, Uriot C, Taourel P. Value of computed tomography in the diagnosis of the cause of nontraumatic gastrointestinal tract perforation. J Comput Assist Tomogr. Mar-Apr 2007;31(2):169-76. [Medline].

  13. Kim JH, Shin JH, Di ZH, Ko GY, Yoon HK, Sung KB. Benign duodenal strictures: treatment by means of fluoroscopically guided balloon dilation. J Vasc Interv Radiol. Apr 2005;16(4):543-8. [Medline].

  14. El-Nakeeb A, Fikry A, Abd El-Hamed TM, Fouda EY, El Awady S, Youssef T, et al. Effect of Helicobacter pylori eradication on ulcer recurrence after simple closure of perforated duodenal ulcer. Int J Surg. Dec 6 2008;[Medline].

  15. Carucci LR, Levine MS, Rubesin SE, et al. Upper gastrointestinal tract barium examination of postbulbar duodenal ulcers. AJR Am J Roentgenol. Apr 2004;182(4):927-30. [Full Text].

  16. Ford AC, Delaney BC, Forman D, et al. Eradication therapy in Helicobacter pylori positive peptic ulcer disease: systematic review and economic analysis. Am J Gastroenterol. Sep 2004;99(9):1833-55. [Medline].

  17. Horton KM, Fishman EK. Multidetector-row computed tomography of the duodenum: technique and clinical applications. Crit Rev Comput Tomogr. 2004;45(5-6):309-34.

  18. Jayaraman MV, Mayo-Smith WW, Movson JS, et al. CT of the duodenum: an overlooked segment gets its due. Radiographics. Oct 2001;21 Spec No:S147-60. [Medline][Full Text].

  19. Lang EK. Transcatheter embolization in management of hemorrhage from duodenal ulcer: long-term results and complications. Radiology. Mar 1992;182(3):703-7. [Medline].

  20. Lanza FL. NSAIDs and the gastrointestinal tract. Abdom Imaging. Jan-Feb 1997;22(1):1-4. [Medline].

  21. Levine MS, Creteur V, Kressel HY, et al. Benign gastric ulcers: diagnosis and follow-up with double-contrast radiography. Radiology. Jul 1987;164(1):9-13. [Medline].

  22. Levine MS, Rubesin SE, Herlinger H, et al. Double-contrast upper gastrointestinal examination: technique and interpretation. Radiology. Sep 1988;168(3):593-602. [Medline].

  23. Rodriguez HP, Aston JK, Richardson CT. Ulcers in the descending duodenum. Postbulbar ulcers. Am J Roentgenol Radium Ther Nucl Med. Oct 1973;119(2):316-22. [Medline].

Keywords

duodenal ulcer, duodenum ulcer, DU, peptic ulcer, gastric ulcer, Helicobacter pylori, H pylori, Zollinger-Ellison syndrome

Contributor Information and Disclosures

Author

Isaac Hassan, MB, ChB, FRCR, DMRD, Former Senior Consultant Radiologist, Department of Radiology, St Bernard's Hospital, Gibraltar
Isaac Hassan, MB, ChB, FRCR, DMRD is a member of the following medical societies: American Roentgen Ray Society and Royal College of Radiologists
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

David Andrew Nicholson, BM, BS, FRCR, Honorary Lecturer, Department of Radiology, University of Manchester; Consultant Gastrointestinal Radiologist, Department of Radiology, Hope Hospital, Salford Royal Hospital NHS Trust
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Radiologist, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
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