True regarding morphological feature of peptic ulcer is: March 2008

Ans. C: Round to oval, sharply punched out defect Peptic ulcer are four times more common in the proximal duodenum than in the stomach. Peptic ulcers are solitary in more than 80% of the patients. Peptic ulcers are sharply punched out with straight walls and a flat base which is smooth. The adjoining mucosa is flat and the rugal folds extend to the margin of the ulcer and some reddening of the adjoining mucosa may indicate an associated gastritis. The gastric mucosa is often flattened due to the presence of chronic gastritis with atrophy. Acute ulcers may show edema and chronic ulcers show varying degrees of underlying fibrosis. The depth of the ulcer is variable with some showing only mucosal involvement in which case they are called erosions in contrast to deeply penetrating ulcers which involve submucosa and deeper layers. Occasionally evidence of active bleeding may be seen, and deep ulcers may perforate. Benign gastric ulcers are most commonly found along the lesser curvature near the interface of the body and antrum. Size and location of the ulcer do not differentiate benign and malignant ulcers. However the gross appearance of chronic peptic ulcer is viually diagnostic. Malignant transformation of the peptic ulcer is very rare.