Barium meal has been frequently used to differentiate malignant and benign gastric ulcers:
Features suggesting benign gastric ulcer
- outpouching of ulcer crater beyond the gastric contour (exoluminal)
- smooth rounded and deep ulcer crater
- smooth ulcer mound
- smooth gastric folds that reach the margin of the ulcer
- Hampton's line
- more often along the lesser curvature of stomach, in gastric body and antrum region
Features suggesting malignant gastric ulcer
- does not protrude beyond the gastric contour (endoluminal)
- irregular and shallow ulcer crater
- nodular and angular ulcer mound
- nodular gastric folds that do not reach the ulcer margin
- Carman meniscus sign
- more often along the greater curvature of stomach
NOTE: Remember Hampton's (Harmless = benign) and Carman (Carcinoma = malignant)
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