peptic duodenitis

peptic duodenitis

A condition caused by chronic exposure to excess hydrochloric acid, which is characterised by inflammation, and most prominent in the duodenal bulb (D1), associated with Helicobacter pylori infection, chronic active gastritis and peptic ulcer disease. Peptic duodenitis is at the banal end of the spectrum of upper GI inflammation, at the other end of which is peptic ulcer disease.

Endoscopy
Erythema (blood is shunted to the tips of the villi), mucosal friability, regional nodularity (Brunner’s gland hyperplasia). There is often a poor correlation between endoscopy and histology; extreme cases are eroded and ulcerated.

DiffDx, duodenitis
Coeliac disease, Crohn’s disease, drug-induced inflammation, parasites, ulcerative colitis.
References in periodicals archive ?
were blinded to the culture results and clinical information and jointly assessed the biopsies for the following features: (1) villous to crypt (v:c) ratio, (2) number of surface and crypt intraepithelial lymphocytes, (3) number of crypt apoptoses, (4) basal plasmacytosis, (5) neutrophilic cryptitis or villitis, (6) peptic duodenitis, (7) accompanying erosions or ulcers, (8) increased mucosal eosinophils, and (9) abnormal absence of goblet cells and/or Paneth cells.
In contrast, there were no significant differences between the 2 groups in any of the other histopathologic features, including villous and crypt intraepithelial lymphocytosis, crypt apoptoses, basal plasmacytosis, neutrophilic cryptitis/villitis, erosion/ulcers, increased mucosal eosinophils, presence of goblet and Paneth cells, or peptic duodenitis (Figures 2, B, and 3).