(C) Incisura angularisGASTRIC ULCERS tend to be larger in comparison to Duodenal Ulcers.Fibrosis results rarely & shown as hourglass contraction of the stomach.Large chronic ulcers may erode posteriorly into the pancreas & erode major vessels such as the splenic artery.Less commonly erode into other organs such as the transverse colon.Chronic gastric ulcers are much more common on the lesser curve (especially at the incisura angularis)Chronic gastric ulcers are less common on the greater curve and, even when high on the lesser curve, they tend to be at the boundary between the acid-secreting and the non-acid-secreting epithelia.With atrophy of parietal cell mass, non-acid-secreting epithelium migrates up the lesser curvature.Major causative factor (60% of gastric & up to 50-75% of duodenal ulcers) is chronic inflammation due to Helicobacter pylori that colonizes the antral mucosa.Majority of Gastric ulcers can be attributed to either H. pylori infection or NSAID induced mucosal damage.Types of Gastric ulcer:Type I - located near the angularis incisura on the lesser curvature, close to the border between the antrum & the body of the stomach.These patients usually have normal or decreased acid secretion.Type II ulcer: Occurs in conjunction with active or healed duodenal ulcer disease.Type III: Prepyloric ulcerType IV ulcer: Gastro esophageal junction at the lesser curve.Type V ulcer: Anywhere in the stomach associated with chronic NSAID use or aspirin use.MOST COMMON SITE OF GASTROINTESTINAL TRACT LESIONS*. Most common site of Perforation of oesophagusOesopahgeal introitus*. Most common site of Oesopahgeal webProximal portion of oesophagus*. Most common site of Carcinoma oesophagusMiddle 1/3rd*. Dilatation of gut in Chaga's diseaseOesopahgus& Colon*. Congenital hour-glass stomachIncisura angularis*. Most common site of Gastric ulcers (95%)Incisura angularis of Lesser curvature*. Most common site of Duodenal ulcers (95%)Within 2 cm of pylorus (duodenal bulb)*. Most common site of Pulsion diverticulum of stomachGreater curvature & posterior fundus*. Carcinoma stomachPrepyloric region*. Carcinoma stomach associated with pernicious anaemiaFundal & polypoid*. Lymphoma (Non Hodgkins)Stomach (least common-Rectum)*. Haemangioma in internal organLiver*. ZES gastrinomaPancreas*. Intestinal rupture in blast injuryPelvic colon*. Crohn's diseaseTerminal Ileum*. Ulcerative colitisSigmoid colon*. Untreated amoebic liver abscess bursts intoRight lung*. Intestinal tuberculosisIleo-caecal region*. Typhoid ulcerSmall intestine (Longitudinal) *. Most common site of Perforation in TyphoidSmall intestine Ileocaecal junction*. Most common site of Meckel's diverticulumFrom the Ileum (60-90 cm from the Ileocaecal valve)*. Pneumatosis cystoidesSmall intestine*. Most common site of Diverticuiosis90% in Sigmoid (Rectum is never involved)*. Polypi in Puetz-Jeghers syndromeAlways jejunum is involved*. Adenomatous polypiSigmoid, Rectum*. Familial polyposis and Gardner's syndromeColon*. LipomaCaecum*. Carcinoma small intestineJejunum*. Most common site of Carcinoma colonsigmoid colon & Rectosigmoid junction*. Carcinoid tumoursAppendix (90%)*. Loop colostomyTransverse colon*. Acute intestinal obstructionIleum*. Intussusception with gangreneIleocaecal*. Intussusception in infantLast 50 cms of Ileum*. Most common site of Intussusception in adolescentThick of inverted Meckel's diverticulum*. Volvulus small intestineIleum*. Perforation in simple obstruction of colon (in absence of strangulation)Caecum*. Intraperitoneal abscessPelvis*. Most common site of Hirschsprung's diseaseUsually upper limit is Rectosigmoid junction