Endoscopic diagnosis of recurrent peptic ulcer due to retained antrum.

Recurrent, peptic ulcer following surgery has a 3% to 10% recurrence rate. Recurrence is due to one of the following causes: incomplete vagotomy, failure of gastric drainage, inadequate gastric resection, Zollinger-Ellison syndrome, hyperplasia of the antral gastric-secreting cells or due to use of nonabsorbable sutures. Lack of or incomplete vagotomy has been the most common cause. Gastric ulcer may follow vagotomy and drainage or proximal gastric vagotomy without drainage, and is presumably due to gastric stasis. A less common cause could be retained antrum mucosa when Biliroth II anastomosis is done. 3,4 Fiberoptic endoscopy has been found to be superior over radiology for diagnosis of a recurrent ulcer.