Benign gastric ulcer: a reliable radiologic diagnosis?

A review of 7,600 double-contrast barium-meal studies performed between 1975 and 1981 revealed 221 gastric ulcers reported as benign. The follow-up for 199 of these was adequate and detected no case of carcinoma. The widespread practice of immediate endoscopy and biopsy for all cases of radiologically benign gastric ulcer represents a misuse of expensive medical resources. When a gastric ulcer is demonstrated clearly as benign on double-contrast examination, there is no need for endoscopic confirmation of the diagnosis.