A 35-year-old male who had a chronic duodenal ulcer for the last six years presents with worsening of symptoms, loss of periodicity of symptoms, pain on rising in the morning, sense of epigastric bloating and post-prandial vomiting. The most likely cause of the worsening of his symptoms is development of: (A) Posterior penetration, (B) Gastric outlet obstruction, (C) Carcinoma, (D) Pancreatitis
Answer is B. Chronic duodenal ulcer after many years undergoes scarring and cicatrisation causing total obstruction of the pylorus. Reference: SRB edition:5 page no. 828