According to the modified Johnson classification of gastric ulcers, which type occurs on the lesser curvature at or near the incisura angularis, with normal acid secretion, and accounts for the majority of gastric ulcers?
- A Type I ✓
- B Type II
- C Type III
- D Type IV
Correct answer: A. Type I
Explanation
Johnson type I ulcers lie on the lesser curvature near the incisura, occur in normal or low acid states, and form the largest group of gastric ulcers. Type II combines a body ulcer with a duodenal ulcer and is associated with acid hypersecretion. Type III is prepyloric with acid hypersecretion, and type IV is a high lesser curvature ulcer near the gastroesophageal junction. Students who remember that duodenal-type physiology accompanies types II and III often wrongly choose C.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
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