Radiographic findings of intractable gastric ulcers with H2-receptor antagonists.

BACKGROUND:To clarify the radiographic characteristics of intractable gastric ulcers with H2-receptor antagonists. METHODS:The radiographic findings at the time of starting treatment were compared between 42 patients with gastric ulcers that did not heal within eight weeks of starting treatment with H2-receptor antagonists (the intractable group) and 58 patients whose ulcers healed within the eight-week period (the tractable group). RESULTS:The following radiographic findings in the intractable group were observed at a significantly higher incidence than those in the tractable group and included: an ulcer located on the angle, linear ulcers, a greater depth, an uneven mound surrounding an ulcer, prominent folds' convergence, an overhanging gastric mucosa, an irregular ulcer base, a shortening of the lesser curvature and a U-shaped deformity of the angle. A multiple logistic regression analysis showed that the following three factors had a significant and independent delaying effect on healing: a U-shaped deformity of the angle, an uneven mound surrounding an ulcer and prominent folds' convergence. The relative risk of these factors were 12.7, 14.4 and 12.5, respectively. CONCLUSIONS:Intractable gastric ulcer with H2-receptor antagonists can be predicted based on the characteristic radiographic findings at the start of treatment.