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.