Development of duodenal ulcer concomitant with successful Helicobacter pylori eradication.

The discovery of an association of the bacterium Helicobacter pylori and gastroduodenal ulcer disease has changed our thinking about the pathogenesis of peptic ulcers. The focus of treatment has been directed away from acid suppression as the only therapeutical component to the additional use of antibiotics for eradication of this microorganism. We present the case of a woman with chronic peptic ulcer disease in whom the development of a duodenal ulcer was documented concomitant with Helicobacter pylori eradication therapy utilizing omeprazole and amoxycillin. This regimen had been successful in both healing another peptic lesion in the duodenal bulb and eradicating Helicobacter pylori, yet it proved unable to prevent the early rise of a new ulcer. In conclusion, this finding suggests that Helicobacter pylori and hypersecretory states are not the only causes of relapsing duodenal ulceration.