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Gastric Ulcer

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General Surgery

Pearls and Pitfalls

  • Gastric ulcers comprise 20% of all peptic ulcer disease and can form in the presence of low to normal acid secretion: Type I and IV Gastric ulcers are not associated with acid hypersecretion, whereas Types II and III ulcers involve acid hypersecretion.

  • All patients with suspected gastric ulcer disease should be evaluated for H. pylori infection.

  • Endoscopy is the diagnostic modality of choice for evaluating gastric ulcer. Multiple biopsies of an ulcer (at least 7) is required to effectively exclude an underlying neoplasm.

  • High suspicion of malignancy should be maintained in older patients with gastric ulcer and those with refractory disease.

  • Persistent ulcers after 12 weeks of maximal medical therapy are considered to have refractory disease and require surgical management.

  • Choice of operative therapy depends upon the type of gastric ulcer encountered.

  • Laparoscopic repair of perforated ulcers have equivalent outcomes when compared with conventional operations.

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Selected Readings

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Author information

Authors and Affiliations

  1. Department of Surgery, University of Michigan, Hong Kong, China

    Cheong J. Lee & Diane M. Simeone

Authors
  1. Cheong J. Lee
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  2. Diane M. Simeone
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Editor information

Editors and Affiliations

  1. Department of Surgery, Deputy Director, Comprehensive Cancer Center University of Alabama School of Medicine, Birmingham, AL, USA

    Kirby I. Bland MD (Fay Fletcher Kerner Professor and Chairman) (Fay Fletcher Kerner Professor and Chairman)

  2. Department of General and Visceral Surgery, University of Heidelberg, Heidelberg, Germany

    Markus W. Büchler MD (Professor of Surgery and Chairman) (Professor of Surgery and Chairman)

  3. Department of Surgery, University Hospital, Santiago, Chile

    Attila Csendes MD, FACS (Hon) (Professor of Surgery and Chairman) (Professor of Surgery and Chairman)

  4. James C. Mason Professor of Surgery Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA

    Michael G. Sarr MD

  5. Department of Clinical and Surgical Sciences, The University of Edinburgh Royal Infirmary of Edinburgh, Edinburgh, UK

    O. James Garden MBChB, MD, FRCS (Ed), FRCP (Ed), FRACS (Hon) (Regius Professor of Clinical Surgery) (Regius Professor of Clinical Surgery)

  6. Department of Surgery, The University of Hong Kong Queen Mary Hospital, Hong Kong, China

    John Wong BSc (Med (Syd)), MBBS (Syd), PhD (Syd), MD (Hon (Syd)), FRACS, FRCS (Edin), FRCS (Glasg), FACS (Hon) (Chair Professor) (Chair Professor)

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© 2009 Springer Science+Business Media, LLC

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Lee, C.J., Simeone, D.M. (2009). Gastric Ulcer. In: Bland, K.I., Büchler, M.W., Csendes, A., Sarr, M.G., Garden, O.J., Wong, J. (eds) General Surgery. Springer, London. https://doi.org/10.1007/978-1-84628-833-3_51

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  • DOI: https://doi.org/10.1007/978-1-84628-833-3_51

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-832-6

  • Online ISBN: 978-1-84628-833-3

  • eBook Packages: MedicineReference Module Medicine

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