Inflammation and ulceration

Ulcerations in stomach (both benign and malignant) and duodenal bulb (benign) is readily imaged. The technique for performing an upper gastrointestinal series are quite complicated indeed, so the pathological area can be missed or interpreted as normal for several reasons. Crohns disease, diverticulitis, intraabdominal abscess etc. are diagnosed with NM imaging with labelled white blood cells.
Nowadays many doctors prefer an endoscopic examination. This is done with a fibreoptic device and allows a direct visualisation of the mucosa. Endoscopy also adds the possibility to perform biopsies of the mucosa and direct sampling to verify Helicobacter pylori which is closely associated with peptic ulcers.

Gastritis/duodenitis can often be diagnosed by barium examnation, but endoscopy is somewhat more specific.

CT can be of value in some instances, especially when lymphoma or a diffuse infiltrating carcinoma (linitis plastica) is suspected. CT also gives an excellent overview of neighbouring structures. Inflammatory changes in the large intestine (colon) are preferably imaged by endoscopy, which is more sensitive than X-ray regarding minor changes.