The presumptive diagnosis is peptic ulcer and testing for H. pylori will confirm that diagnosis. If the mucosal defect had been in the stomach endoscopy would have been warranted to rule out a malignant ulcer and concomitant chronic gastritis caused by H. pylori. However, a carcinoma of the duodenum would be extremely rare. However, if the pain does not resolve with successful eradication of the H. pylori infection, further tests are warranted.