CLINICAL PICTURE OF PYLORIC CHANNEL ULCER

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Abstract
The clinical picture of an uncomplicated peptic ulcer is so characteristic that the diagnosis can be made by history alone. When complications develop, this picture changes. For illustration, the patient having a pyloric obstruction from a long-standing ulcer loses the familiar "pain-food-relief" pattern. Likewise, the patient having a perforated walled-off ulcer will experience a change in the usual ulcer picture. The pain becomes severer, may be aggravated by food, and often radiates to the back. These two complications of peptic ulcer are well recognized by the profession and readily diagnosed. It is not generally appreciated, however, that an ulcer located in the pyloric channel frequently gives rise to a bizzare syndrome, not in the least suggestive of ulcer and often missed entirely. There are conflicting opinions in the literature regarding this type of ulcer. Bockus1states that gastric ulcers in or near the pyloric canal have symptoms resembling those

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