A 52-year-old woman is hospitalized with acute upper gastrointestinal hemorrhage. Endoscopic examination reveal a 2.5 cm ulcer in the area of the incisura angularis. The remainder of the endoscopic examination is normal. Continued bleeding requires operative therapy. Optimal therapy consists of which of the following?
A. Gastrotomy with oversewing of the bleeding site
B. Distal gastrectomy including the area of ulceration
C. Proximal gastric vagotomy and oversewing of the bleeding ulcer
D. Truncal vagotomy, pyloroplasty, and oversewing of the bleeding ulcer
Answer:B
A 52-year-old woman is hospitalized with acute upper gastrointestinal hemorrhage. Endoscopic examination reveal a 2.5 cm ulcer in the area of the incisura angularis. The remainder of the endoscopic examination is normal. Continued bleeding requires operative therapy. Optimal therapy consists of which of the following?
A. Gastrotomy with oversewing of the bleeding site B. Distal gastrectomy including the area of ulceration C. Proximal gastric vagotomy and oversewing of the bleeding ulcer D. Truncal vagotomy, pyloroplasty, and oversewing of the bleeding ulcer