Regurgitant or peptic ulcers of the esophagus almost always occur as lesions that are associated with the short-esophagus type of esophageal hiatal hernia. A small percentage of these lesions 1 are congenital, but most occur as complications of the sliding type of esophageal hiatal hernia or of operations upon the gastric cardia.
Any state which will allow acid gastric or alkaline duodenal secretions to come into prolonged contact with esophageal mucous membrane may produce this type of ulcer (Fig. 1).Vomiting may rapidly produce ulcerative esophagitis. If the ulcerative process is not controlled, it eventually may lead to deep ulceration, formation of stricture, and shortening of the esophagus. Some patients who have regurgitant esophageal ulcers give a long history of functional vomiting. They usually have a hypersensitive gag reflex to the extent that they gag or vomit when they brush their teeth. They induce vomiting when they are under