eMedicine Specialties > Radiology > Gastrointestinal

Gastric Ulcer: Follow-up

Author: Isaac Hassan, MB, ChB, FRCR, DMRD, Former Senior Consultant Radiologist, Department of Radiology, St Bernard's Hospital, Gibraltar
Contributor Information and Disclosures

Updated: Mar 5, 2009

Intervention

Embolization of small branches of the gastric arteries with strips of Gelfoam (Pharmacia & Upjohn Company, Kalamazoo, Mich) or 6-cyanoacrylate has been successful in the management of gastric hemorrhage.10,11,12

Medicolegal Pitfalls

  • Failure to diagnose gastric ulceration and eradicate H pylori infection
  • Failure to assess complete healing of the gastric ulcer and exclude a malignant ulcer
  • Failure to recognize and treat the complications of hemorrhage, perforation, and obstruction, especially in elderly patients
 


More on Gastric Ulcer

Overview: Gastric Ulcer
Imaging: Gastric Ulcer
Follow-up: Gastric Ulcer
Multimedia: Gastric Ulcer
References
Further Reading
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References

  1. Levine MS. Peptic ulcers. In: Gore RM, Levine MS, Bralow L, eds. Textbook of Gastrointestinal Radiology. 2nd ed. Philadelphia, Pa: WB Saunders;. 2000: 514-45.

  2. Levine MS, Rubesin SE. The Helicobacter pylori revolution: radiologic perspective. Radiology. Jun 1995;195(3):593-6. [Medline].

  3. Lanas A, Serrano P, Bajador E, et al. Evidence of aspirin use in both upper and lower gastrointestinal perforation. Gastroenterology. Mar 1997;112(3):683-9. [Medline].

  4. Lanza FL. NSAIDs and the gastrointestinal tract. Abdom Imaging. Jan-Feb 1997;22(1):1-4. [Medline].

  5. Bas G, Eryilmaz R, Okan I, Sahin M. Risk factors of morbidity and mortality in patients with perforated peptic ulcer. Acta Chir Belg. Jul-Aug 2008;108(4):424-7. [Medline].

  6. Koivisto TT, Voutilainen ME, Färkkilä MA. Symptoms, endoscopic findings and histology predicting symptomatic benefit of Helicobacter pylori eradication. Scand J Gastroenterol. 2008;43(7):810-6. [Medline].

  7. Uppalapati SS, Boylan JD, Stoltzfus J. Risk Factors Involved in Patients with Bleeding Peptic Ulcers: A Case-Control Study. Dig Dis Sci. Jul 22 2008;[Medline].

  8. Grassi R, Romano S, Pinto A, Romano L. Gastro-duodenal perforations: conventional plain film, US and CT findings in 166 consecutive patients. Eur J Radiol. Apr 2004;50(1):30-6. [Medline].

  9. Kim HJ, Kim AY, Oh ST, et al. Gastric cancer staging at multi-detector row CT gastrography: comparison of transverse and volumetric CT scanning. Radiology. Sep 2005;236(3):879-85. [Full Text].

  10. Wayne JD, Bell RH Jr. Limited gastric resection. Surg Clin North Am. Oct 2005;85(5):1009-20, vii.

  11. Yee YK, Cheung TK, Gu Q, Chan P, But D, Hung IF, et al. Factors affecting physicians' practices related to Helicobacter pylori infection: effect of experience and mode of practice. Digestion. 2008;78(2-3):77-81. [Medline].

  12. Zippi M, Febbraro I, De Felici I, Mattei E, Traversa G, Occhigrossi G. [Diagnosis and treatment of bleeding peptic ulcer: our experience]. Clin Ter. Jul-Aug 2008;159(4):249-55. [Medline].

  13. Befrits R, Sjostedt S, Tour R, et al. Long-term effects of eradication of Helicobacter pylori on relapse and histology in gastric ulcer patients: a two-year follow-up study. Scand J Gastroenterol. Nov 2004;39(11):1066-72. [Medline].

  14. Glickman MG, Szemes G, Loeb P, Margulis AR. Peptic ulcer of the pyloric region. Am J Roentgenol Radium Ther Nucl Med. Sep 1971;113(1):147-58.

  15. Levine MS. Erosive gastritis and gastric ulcers. Radiol Clin North Am. Nov 1994;32(6):1203-14. [Medline].

  16. Levine MS, Creteur V, Kressel HY, et al. Benign gastric ulcers: diagnosis and follow-up with double-contrast radiography. Radiology. Jul 1987;164(1):9-13. [Medline].

  17. Lim CH, Chalmers DM. Upper gastrointestinal haemorrhage. Postgrad Med J. Aug 2004;80(946):492, 494. [Medline]. [Full Text].

  18. Pattison CP, Combs MJ, Marshall BJ. Helicobacter pylori and peptic ulcer disease: evolution to revolution to resolution. AJR Am J Roentgenol. Jun 1997;168(6):1415-20. [Medline].

  19. Peek RM Jr, Blaser MJ. Pathophysiology of Helicobacter pylori-induced gastritis and peptic ulcer disease. Am J Med. Feb 1997;102(2):200-7. [Medline].

  20. Peura DA. Prevention of nonsteroidal anti-inflammatory drug-associated gastrointestinal symptoms and ulcer complications. Am J Med. Sep 6 2004;117 (suppl 5A):63S-71S.

  21. Schulman A, Simpkins KC. The accuracy of radiological diagnosis of benign, primarily and secondarily malignant gastric ulcers and their correlation with three simplified radiological types. Clin Radiol. Jul 1975;26(3):317-25.

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Keywords

gastric ulcer, peptic ulcer, stomach ulcer, Helicobacter pylori, H pylori, mucosal break, nonsteroidal anti-inflammatory drugs, NSAIDs

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Contributor Information and Disclosures

Author

Isaac Hassan, MB, ChB, FRCR, DMRD, Former Senior Consultant Radiologist, Department of Radiology, St Bernard's Hospital, Gibraltar
Isaac Hassan, MB, ChB, FRCR, DMRD is a member of the following medical societies: American Roentgen Ray Society and Royal College of Radiologists
Disclosure: Nothing to disclose.

Medical Editor

John L Haddad, MD, Clinical Associate Professor, Department of Radiology, Weill Medical College of Cornell University; Director of Body MRI, Department of Radiology, Methodist Hospital in Houston
John L Haddad, MD is a member of the following medical societies: American College of Radiology, American Medical Association, and Radiological Society of North America
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

David Andrew Nicholson, BM, BS, FRCR, Honorary Lecturer, Department of Radiology, University of Manchester; Consultant Gastrointestinal Radiologist, Department of Radiology, Hope Hospital, Salford Royal Hospital NHS Trust
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Radiologist, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
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