Gastric ulcers in the fundic gland area

Gastric ulcers have been thought to occur only in the pyloric gland area. However, endoscopic examinations using the Congo red test showed that 18 of the ulcers examined (7.8%) were surrounded by an acid-secreting area, and so were in the fundic gland area. Histological examination of specimens obtained by gastrectomy also showed that five of the lesions examined (4.5%) were located in the fundic gland area. Ulcers in the fundic gland area were found most frequently in the angle and lower gastric body, adjacent to acid-secreting boundary. These ulcers were associated with little or no fundal gastritis, whereas ulcers in the pyloric gland area were usually associated with moderate or severe fundal gastritis. Unlike ulcers of similar depth in the pyloric gland area, ulcers surrounded by normal fundic mucosa healed rapidly and completely. No recurrence of these ulcers was seen in a 1-year endoscopic follow-up period.