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Medicine General 6910d088

A posteriorly perforating ulcer in the pyloric antrum of the stomach is most likely to produce initial localized peritonitis or abscess formation in the following:

A
Omental bursa (lesser sac)
B
Greater sac
C
Right subphrenic space
D
Hepato renal space (pouch of Morison)
High-Yield Explanation
Answer is A (Omentum bursa) "Gastric ulcers perforate into the lesser sac, which can be paicularly difficult to diagnose" - Bailey "A gastric ulcer perforates into the lesser sac, then no signs of generalised peritonitis can be seen but misleading symptoms may appear" - Schwaz As can be seen from the figure, a posteriorly perforating ulcer of the stomach will localize in the lesser sac or omental bursa only. (lesser sacis synonymous with omental bursa)

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