title: Preferential location of idiopathic peptic ulcers.
abstract: OBJECTIVE
  Helicobacter pylori infection-negative, nonsteroidal antiinflammatory drugs (NSAIDs)-negative peptic ulcers, which are termed idiopathic peptic ulcers (IPUs), have been increasing worldwide. In this study, we investigated the preferential locations of gastric ulcers according to their cause (e.g., H. pylori and NSAIDs), with special attention to IPUs.
  
  
  METHODS
  A total of 361 patients consecutively diagnosed with a peptic ulcer over a period of one year were classified into four groups according to H. pylori-infection status and NSAIDs usage. The ulcer location was divided into the antrum, angularis, and body, and was compared among the four ulcer groups.
  
  
  RESULTS
  The ulcers of 43 patients were classified as IPUs. Compared with simple H. pylori ulcers, IPUs more preferentially located in the antrum (14% vs. 52%, p < 0.01). The difference was more pronounced in the analysis of IPUs in which patients with a history of H. pylori eradication or those with severe atrophic gastritis were excluded, and 79% of these IPUs were located in the antrum. With duodenal ulcers taken together, the vast majority of (86%) these IPUs occurred in the duodenal bulb or the antrum. The proportion of antral ulcers in NSAISs users also differed depending on the presence of concomitant H. pylori infection (positive: 22% vs. negative: 62%, p < 0.01).
  
  
  CONCLUSIONS
  There was a striking difference in the ulcer location within the stomach depending on the cause of the ulcer, and IPUs predominantly occurred in the antrum. This information on the preferential locations of ulceration should provide endoscopists with some hints concerning the etiology of ulcers.
authors: a Division of Gastroenterology , Tohoku University Graduate School of Medicine , Sendai , Japan ;|b Department of Gastroenterology , Akita University Graduate School of Medicine , Akita , Japan ;
authors: Katsunori
authors: K
authors: Iijima
authors: a Division of Gastroenterology , Tohoku University Graduate School of Medicine , Sendai , Japan ;
authors: Takeshi
authors: T
authors: Kanno
authors: c Department of Gastroenterology , Yamagata University Faculty of Medicine , Yamagata , Japan ;
authors: Yasuhiko
authors: Y
authors: Abe
authors: c Department of Gastroenterology , Yamagata University Faculty of Medicine , Yamagata , Japan ;
authors: Makoto
authors: M
authors: Yagi
authors: d Department of Gastroenterology , South Miyagi Medical Center , Ogawara , Japan ;
authors: Sho
authors: S
authors: Asonuma
authors: e Department of Gastroenterology , Osaki Citizen Hospital , Osaki , Japan.
authors: Motoki
authors: M
authors: Ohyauchi
authors: e Department of Gastroenterology , Osaki Citizen Hospital , Osaki , Japan.
authors: Hirotaka
authors: H
authors: Ito
authors: a Division of Gastroenterology , Tohoku University Graduate School of Medicine , Sendai , Japan ;
authors: Tomoyuki
authors: T
authors: Koike
authors: a Division of Gastroenterology , Tohoku University Graduate School of Medicine , Sendai , Japan ;
authors: Tooru
authors: T
authors: Shimosegawa
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D004386:Duodenum / Q000473:pathology; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000139:chemically induced / Q000209:etiology / Q000473:pathology*; D011706:Pyloric Antrum / Q000473:pathology; D013270:Stomach / Q000473:pathology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Gastric atrophy; H. pylori; idiopathic peptic ulcers; nonsteroidal antiinflammatory drugs; preferential location