suspected peptic ulcer

suspected peptic ulcer

Gastroduodenoscopy oper - In the stomach, any abnormal lesion should be biopsied, and in the case of a suspected benign gastric ulcer numerous biopsies must be taken in order to exclude, as far as possible, the pres - ence of a malignancy . Commonly , biopsies of the antrum will be taken to see whether there is histological evidence of gastri - tis and a Campylobacter -like organism (CLO) test performed to determine the presence of H. pylori . A ‘U’ manoeuvre should be carried out to inspect the incisura, lesser curve - and gastro-oesophageal junction (GOJ), given the increasing incidence of cancer at the GOJ (see Chapter 66 ). Similarly , if a stoma is present, for instance after gastroenterostomy or Billroth II gastrectomy , it is important to enter both a ff erent y and e ff erent loops. Almost all stomal ulcers will be close to the junction between the jejunal and gastric mucosa. Attention should be given to the pylorus to note whether there is any prepyloric or pyloric channel ulceration, and also whether it is deformed, which is often the case with chronic duodenal ulceration. In the duodenum, care must be taken to view all of the first part and the endoscope advanced into the second part.