Some Gastroscopic Observations in Gastric Ulcer

Abstract

Gastroscopy is a routine procedure in all cases of gastric ulcer seen in the Section on Gastro-intestinal Diseases at the Cleveland Clinic.

We believe that every case of gastric ulcer should have gastroscopic examinations because gastroscopy serves several purposes. First, it is one more way of confirming the clinical and roentgen diagnosis of benign gastric ulcer. Second, by gastroscopy one is better able to follow the course of the disease and to observe completed healing. Third, the persistence or healing of an associated gastritis may be observed. Fourth, when the clinical or roentgen evidence is not sufficient to make a definite diagnosis of ulcerating carcinoma, gastroscopy may add enough additional data to justify a definite diagnosis of a benign or malignant lesion. We believe, further, that gastroscopy should be done in all patients with negative roentgen findings but with definite gastrointestinal symptoms, especially the ulcer-like syndrome. The following cases represent typical examples of the more common problems which are encountered.

The value of direct visualization in confirming or contradicting the roentgen and clinical diagnosis is shown in the following case.

Case 1: This patient was a forty-eight year old nurse whose presenting symptom was “stomach trouble.” She had had distress intermittently for twenty years, characterized by bloating, belching, and occasional sour regurgitations, coming on half an hour after eating. At times there was relief from the use of soda, and at other times a bowel movement would give relief. Laxatives were used frequently.

Physical examination and the routine laboratory tests. . .