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Published on: July 21, 2023
MDCT diagnosis of gastroduodenal ulcers: key imaging features with endoscopic correlation
D R Kitchin1, M G Lubner, C O Menias
1Department of Radiology, University of Wisconsin, 600 Highland Ave., Madison, WI, 53792, USA, dkitchin@uwhealth.org.
Abstract:
Although the overall prevalence of peptic ulcer disease (PUD) and related hospitalizations are decreasing, the initial presentation of complicated PUD on CT remains common. It, therefore, remains critical for radiologists to recognize the findings of PUD at CT for initial diagnosis. While the CT findings of complicated PUD have been previously described in the literature, the CT findings of uncomplicated PUD have not been well documented. Furthermore, although CT is certainly not the diagnostic evaluation of choice for patients with suspected uncomplicated PUD, many patients with PUD will nonetheless present to the emergency department with unexplained abdominal pain and undergo MDCT evaluation as the initial diagnostic test. Therefore, recognizing the MDCT findings of uncomplicated PUD can help appropriately direct patient management, and help prevent the development of complications. To facilitate improved recognition of PUD on abdominal CT, we present an overview of the CT findings of both uncomplicated and complicated PUD, as well as several diagnostic pitfalls which can result in misdiagnosis from peptic ulcer mimics.
Insights
Radiologists must recognize computed tomography (CT) findings for diagnosing peptic ulcer disease (PUD), even uncomplicated cases. This overview aids in identifying PUD on CT scans to prevent complications.
Area of Science:
- Radiology
- Gastroenterology
- Medical Imaging
Background:
- Peptic ulcer disease (PUD) prevalence and hospitalizations are declining.
- Complicated PUD presentations on CT scans remain common, necessitating radiologist recognition.
- CT findings for uncomplicated PUD are less documented than for complicated PUD.
Purpose of the Study:
- To provide an overview of CT findings for both uncomplicated and complicated PUD.
- To improve the recognition of PUD on abdominal CT scans.
- To highlight diagnostic pitfalls and potential misdiagnoses from peptic ulcer mimics.
Main Methods:
- Review of existing literature on CT findings in PUD.
- Analysis of CT scans demonstrating uncomplicated and complicated PUD.
- Identification and description of common diagnostic pitfalls.
Main Results:
- CT findings for complicated PUD are well-established.
- CT findings for uncomplicated PUD are less consistently documented but crucial for early diagnosis.
- Several mimics can lead to misdiagnosis if not carefully considered.
Conclusions:
- Recognizing CT findings of PUD, including uncomplicated cases, is critical for initial diagnosis and management.
- MDCT evaluation is often the initial diagnostic test for patients with unexplained abdominal pain, making PUD recognition important.
- Improved understanding of CT findings can prevent PUD complications and guide appropriate patient management.
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