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Endoscopic morphology of duodenal ulcer (DU) have been studied in 188 patients repeatedly observed in the course of medical therapy (120 with conventional therapy and 68 with Cimetidine alone). The evolutive behaviour under treatment reveals a clear speeding up effect of Cimetidine on the healing time with a smaller number of failed and delayed recoveries and a lower frequency of relapses than after conventional therapy. Endoscopic morphology allows a limited but significant forecast of therapeutic outcome of DU. The shape, the number and partly the location of ulcer in the bulb appear to be the most significant parameters with prognostic influence both on the healing time and on the frequency and early development of relapses.

The prevalence of erosive lesions was found to be 27.5% in 11838 cases examined during the last 10 years. In almost 66% of the cases, erosive lesions were localized in the duodenal bulb but mainly isolated and less often in the antro-pyloric area. In 55% of the cases, duodenal erosions coexist with ulcerative peptic disease, 20% in "active" phase and 35% in "inactive" phase. Erosive lesions, appeared autonomously in 45% of the cases. Morphologically, they can be divided in: a) periulcerative marginal erosions closely connected with activity of the ulcers; b) clustered, complete or incomplete erosions, which may or may not be associated with the ulcerative disease and often have a prolonged acyclic behaviour; c) scattered flat erosions which can at times be associated with the ulcerative peptic disease but are always related to a chronic widespread duodenitis. An epidemiological study was performed on 564 cases which were divided into 3 groups: a) cases with autonomous erosive disease; b) those with erosions associated with post-ulcerative scars; and c) those with erosions associated with active ulcers. The control group of 111 cases was characterised by duodenal active ulcers with no erosions. Statistical evaluation of the percentage differences between the 4 groups revealed that in duodenal erosive disease predisposing factors such as psychic temper, environmental and work conditions and eating habits are evident. In autonomous disease drug intake and spices and, to a less extent, alcohol and/or stress situations play a more important role. In erosions associated with an active ulcer, a dominant obsessive temper facilitated by a difficult family situation, bad eating habits and a great amount of smoking are prominent factors.(ABSTRACT TRUNCATED AT 250 WORDS)