Ischaemic gastric ulceration with endoscopic healing after revascularization.
A 66-year-old man with a history of abdominal pain, diarrhoea and weight loss was admitted for evaluation. Gastroscopy disclosed a severe gastric ulceration covering the lesser curvature. There was none of the usual risk factors for peptic ulcer disease and no malignancy was found. After 2 weeks' treatment with a proton pump inhibitor no healing was observed. The patient had a known atherosclerotic vascular disease, and angiography disclosed severe mesenteric ischaemia. After a revascularization procedure with stenting of the superior mesenteric artery was performed, the patient's symptoms disappeared. Healing of the gastric ulceration was observed at a further gastroscopy 2 weeks later. Chronic ischaemia is a rare cause of gastric ulcer, but should be suspected when no other cause is found and when the usual treatment with proton pump inhibitors does not result in healing.
Department of Medicine, Randers Hospital, Randers, Denmark.
Sabine
S
Becker
Ole K
OK
Bonderup
Tage O
TO
Fonslet
D000368:Aged; D000800:Angioplasty, Balloon; D006801:Humans; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000150:complications / Q000628:therapy*; D008297:Male; D017538:Mesenteric Artery, Superior; D008641:Mesenteric Vascular Occlusion / Q000628:therapy*; D015607:Stents; D013276:Stomach Ulcer / Q000209:etiology / Q000628:therapy*