False Filling Defects in Large Gastric Ulcers

Radiological diagnosis of exceptionally large gastric ulcers has been a source of confusion and embarrassment for the radiologist over the years. We have recently had 5 cases of large peptic ulcers which were associated with prominent central filling defects. Frequently there is so much distortion of normal anatomy that it is difficult to recognize the ulcer crater. The barium, in most of the cases, appeared segmented into three parts, and the middle segment contained the filling defect. This was so prominent, in some of the cases, as to lead to the diagnosis of a polypoid growth. Knowledge of the surgical findings in 2 instances led to a correct interpretation of 2 others. Case History Case I: M. P. was a 41-year-old female who had several nonspecific complaints with only intermittent epigastric pain sometimes relieved by milk or alkali. She vomited a large amount of blood in the doctor's office and was taken to the hospital in shock. Transfusions were given, and three days later an upper gastrointestina...