Johnson described 3 types of gastric ulcers based on location and pathogenesis. A fourth type was reported by Csendes et al.
Location: Ulcers tend to occur at junctions between different mucosal types (oxyntic-antral, antral-pyloric, esophago-gastric).
body of stomach
low to normal
body of stomach and duodenum
prepyloric or pyloric (within 2 cm of pylorus)
subcardial or juxtacardial (within 4 cm of squamocolumnar junction)
• Type II or III ulcerations may be treated with vagotomy because of acid hypersecretion.
• Type III ulcers are also referred to as pyloric channel ulcers.
diffuse antral gastritis or multifocal atrophic gastritis
perforation or obstruction
massive or recurrent bleeding, deep penetrating ulcer without perforation, slow gastric emptying
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Specialty: Gastroenterology, Infectious Diseases, General Surgery