**Question:** Following are common features of malignant gastric ulcer on Barium meal, Except -

A. Incomplete filling of the stomach
B. Early passage of barium through the ulcer
C. Distention of the stomach
D. Poor barium contrast study

**Core Concept:** Malignant gastric ulcers are a result of malignancy invading the gastric wall, leading to the formation of ulcers. These ulcers often exhibit specific findings on barium meal studies.

**Why the Correct Answer is Right:**

Correct Answer: D. Poor barium contrast study

Explanation: Poor barium contrast study means that the barium does not adequately fill the stomach or show proper contrast between the stomach and surrounding organs. In the case of malignant gastric ulcers, this finding is not specific and can occur due to various causes like narrowing of the stomach caused by obstruction by the tumor or stricture, or due to peristaltic dysfunction. These causes are not specific to malignant gastric ulcers and can be seen in other conditions as well.

**Why Each Wrong Option is Incorrect:**

A. Incomplete filling of the stomach (Correct Answer D) - This finding can occur due to obstruction by the tumor or stricture and is not specific to malignant gastric ulcers.

B. Early passage of barium through the ulcer (Correct Answer B) - This finding is not specific to malignant gastric ulcers, as it can also occur in cases of benign ulcers.

C. Distention of the stomach (Correct Answer C) - This finding can be seen in various causes such as poor oral intake, delayed gastric emptying, or obstruction, and is not specific to malignant gastric ulcers.

**Clinical Pearl:**

A common pitfall in interpreting barium studies is the assumption that every finding is specific to malignant gastric ulcers. Adequate knowledge of the various causes for each finding is crucial to avoid misdiagnosis. A thorough clinical examination, imaging studies, and endoscopy are essential for accurate diagnosis.

**Correct Answer:** C. Distention of the stomach

In conclusion, distention of the stomach is not specific to malignant gastric ulcers and can be seen in various causes like poor oral intake, delayed gastric emptying, or obstruction. Thus, this finding is not a reliable indicator of malignant gastric ulcers on barium meal studies.