Types of gastric ulcers
There are Five types of gastric ulcers in terms of location, gastric acid secretory status, incidence, and complications.
Peptic ulcers are a common cause of upper gastrointestinal (GI) symptoms with peak incidence in middle-aged men (55-65). They arise at various locations, including the stomach (gastric ulcer), duodenum (duodenal ulcer), and esophagus (esophageal ulcer). Gastric ulcers are further divided into five types based on location, secretory status, and cause.
The Five Types of Gastric Ulcers by Location, Gastric Acid Secretory Status, Complications, and Incidence
| Type | Location | Acid Hypersecretion | Complications | Incidence |
|---|---|---|---|---|
| I | Gastric body, lesser curvature | No | Bleeding uncommon | 55% |
| II | Body of stomach + duodenal ulcer | Yes | Bleeding, perforation, obstruction | 20% |
| III | Prepyloric | Yes | Bleeding, perforation | 20% |
| IV | High on lesser curvature | No | Bleeding | < 5% |
| V | Anywhere (medication induced) | No | Bleeding, perforation | < 5% |
The literature generalizes the findings of examination and experience in the surgical treatment of 404 patients with gastric ulcers.
A classification of gastric ulcers is suggested: Type I, true gastric ulcers; Type II, combined gastric and duodenal ulcers; Type III, suprapyloric and pyloric ulcers; Type IV, multiple ulcers of the stomach; Type V, secondary gastric ulcers.
On the basis of this classification the authors substantiate the wide use of modified resections of the stomach after Billroth I.
Chronic disorders of duodenal patency was revealed in 10 (2.47%) of patients who underwent operation, compensated duodenal stasis was encountered in only one of them.
Billroth I operation was performed on 357 (88.4%) patients and Billroth II on 47 (11.6%) patients. The postoperative mortality was 1.73%. The Billroth I operation produced excellent and good late-term results in 90.1% of patients with gastric ulcers.
