Radiologic investigation of peptic ulcer disease

Fiberoptic endoscopy has uncovered some of the weaknesses with the traditional upper gastrointestinal series and has prompted more critical evaluation of the radiographic examination of the stomach. The biphasic examination using gas distention as well as thick and thin barium suspensions incorporates the best features of both single- and double-contrast examinations. The radiologist needs to be aware of the different signs of ulcer disease as demonstrated by the two different types of examinations, and attention to technical details is critical if thick barium coating is really going to produce striking anatomic detail. Knowing the radiographic features of the common and uncommon manifestations of peptic ulcer disease is important for the radiologist performing gastrointestinal studies. By performing technically excellent studies and by recognizing the various manifestations of peptic ulcer disease, the radiologist will continue to play an important role in diagnosing suspected or known peptic ulcer disease.