Case

A patient comes to your practice complaining of a severe and constant burning pain in the upper left quadrant and symptoms of nausea, vomiting, and bloating. The patient has a history of stomach ulcers.  Upper GI endoscopy shows that the patient has a perforating ulcer in the posterior mid body of the stomach that is leaking gastric fluid out of the stomach.

Question 3/3 - Gastric ulcers can erode into adjacent blood vessels. Which vessel would be of concern with this ulcer?

Click on your selected option(s) below  (correct = 1,  over-thinking = 2+)

Case Complete

Incorrect. The left gastric courses around the lesser curvature of the stomach which is on the superior side of the stomach, not the posterior. An ulcer on the superior aspect of the stomach can put the left gastric at risk (and is actually a common location for ulcers to form).

Incorrect. The gastro-omental artery courses around the greater curvature of the stomach which is on the inferior side of the stomach. Additionally, it runs within the greater omentum approximately 1 inch inferior to the stomach giving some distance from potential ulcers.

Incorrect. The proper hepatic artery is a branch of the common hepatic and travels within the hepatoduodenal ligament. Thus, it is not posterior to the mid-body of the stomach.

Incorrect. The gastroduodenal artery is a branch of the common hepatic and turns inferiorly to supply duodenum, pancreas, and the right gastro-omental artery. Thus, it is not posterior to the mid-body of the stomach. Ulcers in the pyloric region of the stomach could erode into the gastroduodenal artery (another common region for ulcers).

Incorrect. The right renal artery is on the right side, the stomach is on the left.

Correct! The splenic artery travels along the superior edge of the pancreas and is located directly posterior to the stomach. An ulcer in the posterior mid-body of the stomach has the possibility to erode into this artery (although this is uncommon and would be associated with massive bleeding as the splenic is a substantial diameter artery).