The bleeding gastric ulcer - will it bleed again, and if so, why? A case for repeat endoscopy in evaluating stigmata

Shuttleworth R.D. ; Falck V.G. (1984)

Article

The original publication is available at http://www.samj.org.za

Article

Nine patients qualified for surgery for a bleeding gastric ulcer - all had a 'visible vessel'. Three of these vessels were thrombosed including 2 in patients who had been in shock. The smallest patent vessel was 0,35 mm in diameter, and 6 of the bleeding vessels were subserosal. The features thought to predispose to further bleeding were vessel size, a lateral hole in the main trunk of the vessel and, possibly, previous recanalization or ingestion of a drug which affected haemostasis. Five of 6 patent arteries had a cap of thrombus over the breach forming a false aneurysm. It is suggested that clinically these should pulsate, enlarge, leak - with persistent fresh thrombus in the ulcer crater on repeat endoscopy - and finally rupture. Where the underlying vessel is thrombosed the stigmata of a non-pulsatile 'visible vessel' or thrombus in the ulcer should disappear on repeat endoscopy. The sizes of the arteries in the normal antrum are tabulated.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/7554
This item appears in the following collections: