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Duodenal ulcer first part of the duodenum ETIOLOGY (CAUSES) Helicobacter pylori infection (most common) NSAIDs / Aspirin (inhibit prostaglandins) Severe physiological stress (burns, head injury Curling/Cushing ulcers) Smoking Alcohol (risk factor) ZollingerEllison syndrome (gastrinoma) Corticosteroids (with NSAIDs) Chronic systemic illness PATHOPHYSIOLOGY Imbalance between: Aggressive factors: gastric acid, pepsin, H