Linear niches in the duodenal bulb

Twenty-three linear niches in the duodenal bulb were found in 22 patients out of a series of 314 patients with radiographically demonstrated duodenal ulcers (incidence 7%). Double-contrast and single-contrast graded-compression views were effective in depicting the linear niche in four cases. In 14 cases only double-contrast films showed the abnormality, while in four cases the diagnosis could be made only on positive-contrast graded-compression films. Optimal distension proved to be essential in both techniques. All niches were transversely oriented in the duodenal bulb. In 18 cases the niche occurred in a deformed bulb, and in four cases there was no deformity. Radiologic differentiation between a thin, active, linear ulcer and a linear scar was not possible.
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