Refractory Gastric Ulceration



Question: A 58-year-old man was referred to our unit by another hospital for consideration of performing a vagotomy to treat multiple gastric ulcers that had proved difficult to heal as seen on repeated esophago-gastro-duodenoscopies (EGDs) and with long courses of high-dose antiulcer drugs. He originally experienced an 8-month history of losing 12 kg in weight and upper abdominal pain that was aggravated by eating. The referring hospital had investigated him with 3 EGDs, which showed persistent multiple gastric ulcers, 2 in the body and 1 in the antrum, 2–4 cm in diameter; an abdominal computed tomography (CT) scan, which was described as unremarkable; and blood tests that had shown normal renal and liver functions.

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