This A 56-year-old white female was admitted to the hospital with a six-year history of severe epigastric pain and burning. This pain , which has occurred intermittently for the Last 4 years was said to be worse at night and on an empty stomach. The patient reported that the pain was relieved by drinking milk. She had also experienced several episodes of hematemesis and melena since the onset of the pain, the last episode occurring 3 weeks prior to admission. The patient described intermittent episodes of colicky pain An upper endoscopy was performed which demonstrated an ulcer in the right upper quadrant and right side of the abdomen, frequently radiating to the back and shoulders and often accompanied by "bilious vomitinggastric mucosa." Physical examination A breath test for Helicobacter pylori was noncontributory except for tenderness in positive so the epigastrium patient was started on antibiotics and right upper quadrantproton pump inhibitors (PPI). An upper GI series showed changes suggestive of  Autopsy pictures and histology sections from a neoplasm. The different patient submitted to an abdominal exploration at which time a partial gastrectomy was performedwith peptic ulcer disease are presented.

File:IPLab3ChronicPepticUlcer1IPLab3ChronicPepticUlcer1b.jpg|This is a gross photograph of a stomach containing an ulcertwo ulcers. Note the folded pink gastric mucosa that extends up to the edge of the ulcer (arrows).

File:IPLab3ChronicPepticUlcer3IPLab3ChronicPepticUlcer3b.jpgJPG|This is a low-power photomicrograph of a section through the transected ulcer. The blue cells on the right hand side of this section are the normal gastric epithelial cells of the mucosa (1). Note the absence of any epithelial cells within the crater of the ulcer (2).File:IPLab3ChronicPepticUlcer4IPLab3ChronicPepticUlcer4b.jpgJPG|This is a photomicrograph of the margin of the ulcer. Note the intact epithelium on the right side of the section (1) and the ulcerated region without epithelium on the left (2). There are numerous inflammatory cells within this tissue.File:IPLab3ChronicPepticUlcer5IPLab3ChronicPepticUlcer5b.jpgJPG|This is a medium-power photomicrograph of the base of the ulcer with the fibrinopurulent membrane (1) overlying the ulcerated surface. The ulcerated surface contains granulation tissue and inflammatory cells (2).File:IPLab3ChronicPepticUlcer6IPLab3ChronicPepticUlcer6b.jpgJPG|This high-power photomicrograph of the ulcer base (arrows) demonstrates the lack of epithelium and the exuberant inflammatory response (1) consisting of primarily of fibrin and neutrophils (and adherent gastric secretionsPMNs) and PMNs. The surface of the ulcer bed is covered with this fibrinopurulent exudate.File:IPLab3ChronicPepticUlcer7IPLab3ChronicPepticUlcer7b.jpgJPG|This high-power photomicrograph of the ulcer base demonstrates plump, activated fibroblasts and endothelial cells (arrows) within the granulation tissue that makes up the base of the ulcer. There are inflammatory cells (primarily lymphocytes) within this region as well.File:IPLab3ChronicPepticUlcer8IPLab3ChronicPepticUlcer8b.jpgJPG|This low-power photomicrograph demonstrates the healing reaction in the base of this ulcer. The base of the ulcer is at the left-hand side top of the image and the serosal surface is at the rightbottom. Note the granulation tissue and fibrous connective tissue within the wall of the stomach (1) and the layer of inflammatory exudate on the surface of the ulcer (arrow).File:IPLab3ChronicPepticUlcer9.jpg|This high-power photomicrograph demonstrates the granulation tissue within the base of the ulcer.File:IPLab3ChronicPepticUlcer10.jpg|This is a photomicrograph of the serosal surface (1) from a section of stomach near the ulcer. Note that the inflammatory reaction extends out to the serosa.File:IPLab3ChronicPepticUlcer11.jpg|This is a trichrome-stained section of tissue demonstrating fibrous connective tissue scar formation (blue color) in this lesion. The surface of the ulcer is at the left-hand side of the image. There is a layer of inflammatory cells and RBCs on the surface of the ulcer.

* Mackie DB, Gent AELaine L. [http://www.ncbinejm.nlm.nih.govorg/pmcdoi/articles10.1056/PMC2491545/ Management of upper gastrointestinal haemorrhageNEJMcp1514257 Upper Gastrointestinal Bleeding Due to a Peptic Ulcer.]. ''Ann R Coll Surg EnglNEJM'' 1977 January2016 June 22; 59(1)374: 56–602367-2376.

* [http://peir.path.uab.edu{{SERVER}}/library/index.php?/tags/122-peptic_ulcer PEIR Digital Library: Peptic Ulcer Images]