More than 100 years ago (1829) Cruveilhier4 made the observation that chronic gastric ulcers are usually situated at the lesser curvature. This has been confirmed by many writers, but no valid explanation for this peculiar localization has come forward.
There is strong evidence (Bolton2 and Konjetzny9) that chronic gastric ulcers arise from acute ulcers. Thus two problems present themselves: first, the cause of acute ulcers, and, second, the factors which lead to the persistence or nonhealing of ulcers. Acute ulcers are found not only at the lesser but also on the greater curvature, and at the cardia as well as in the fundus (Stewart15). Their etiological factors—chemical, hormonal, neurological, and psychological—have been widely discussed in modern treatises. However, very little attention has been given to the second problem: Why ulcers at the lesser curvature become chronic. The peculiar localization of almost all chronic stomach ulcers at
HELLWIG CA, WELCH JW, WILKINSON PN. Localization of Stomach Ulcers. AMA Arch Surg. 1958;76(3):331-333. doi:10.1001/archsurg.1958.01280210001001