Arhus county vagotomy trial. Acid secretory patterns in patients with prepyloric, pyloric, and duodenal ulcer

Abstract

Prepyloric (PPU), pyloric (PU), and duodenal bulb ulcers (DU) are traditionally incorporated in the clinical entity 'duodenal ulcer disease'. Clinical and gastric secretory data were analyzed with respect to the ulcer location in a prospective study with complete data from 776 patients. 574 had DU, and the female/male ratio was 0.39. 95 had PU (female/male ratio = 0.61) and 107 PPU (female/male ratio = 0.53). The higher female/male ratio for PU and PPU as compared to DU was significant. The age distribution showed a significant trend to younger age representation of males in the DU group, while the age distribution of the females was equal for the three groups. The duration of symptoms before elective surgery was equal for all three groups. The pentagastrin-stimulated peak acid output was significantly higher for DU compared to PPU, and this applied for both sexes even when the values were corrected for body weight as well as for age differences. Our results indicate DU and PPU to be materially different while PU constitute an intermediary group.