Clinical features: The term peptic ulceration and rarely in the ileum adjacent to a Meeke's diverticulum refers to an ulcer in the lower oesophagus, stomach and duodenum. In the duodenum ulcers may develop after surgical anastomosis to the stomach. They have in common the participation of acid-pepsin in their pathogenesis. The common ulcers are duodenal and/or gastric. Peptic ulcer may present in many different ways. The commonest is chronic, episodic pain persisting for months or years. However, the ulcer may come to attention as an acute episode with bleeding or perforation, with little or no previous history. As with duodenal ulcer epigastric pain is the commonest symptom of gastric ulcer.