Well-defined rounded ulcer with undermined edge. There is diffuse hyperemia due to associated duodenitis.
Chronic peptic ulcer duodenum
Seen above are gastric ulcers of small, & large size on upper endoscopy. All gastric ulcers are biopsied, since gross inspection alone cannot determine whether a malignancy is present. Smaller, more sharply demarcated ulcers are more likely to be benign.
Gastric ulcers of various sizes (Endoscopic views)
Chronic peptic ulcer
Sharply delimited chronic peptic ulcer with converging folds of mucosa (due to underlying fibrosis). This gives a spoke- or star-like appearance."Hourglass" stomach
Due to chronic peptic ulceration there is fibrosis and contracture of the stomach leading to an hourglass shape as well as altered mobility.Whole mount view of chronic peptic ulcer. The external muscle layer has been totally destroyed. Note the overhanging mucosa on one edge and the sloping mucosa on the other.
Chronic peptic ulcer stomach
Chronic peptic ulcer shows four layers The base and walls have a superficial thin layer of necrotic fibrinoid necrosis. Beneath this layer is a zone of predominantly neutrophilic inflammatory infiltrate. Deeper still, there is granulation tissue infiltrated with inflammatory cells. This rests on Fibrous or collagenous scar.
There are multiple, small (less than 1 cm) and circular defects. The ulcer base is frequently stained a dark brown by the acid digestion of blood. The related mucosal folds (rugae) are normal (cf. chronic peptic ulcer, which show convergence on the ulcer)
Acute gastric ulcers