Anastomotic Ulcer

Anastomotic (marginal/stomal) ulcer is ulcer at the gastrojejunal anastomosis after gastric surgery, due to acid exposure, H. pylori, NSAIDs, or retained gastric antrum/Zollinger-Ellison, presenting with epigastric pain, bleeding, and possible perforation/obstruction. Treatment: high-dose PPI; H. pylori eradication if positive; stop NSAIDs; evaluate ZES (gastrinoma); endoscopy with biopsy; treat complications (bleeding/perforation/obstruction) endoscopically or surgically; revisional surgery if refractory; long-term PPI; follow-up endoscopy.

Common Symptoms

Epigastric pain; bleeding; after gastric surgery; by acid/H. pylori/NSAID/ZES

Causes and Pathogenesis

Acid exposure at anastomosis causes marginal ulceration.

Treatment

High-dose PPI; H. pylori; stop NSAIDs; evaluate ZES; treat complications; revisional surgery if refractory

Preventive Measures

H. pylori treatment; avoid NSAIDs; long-term acid suppression after gastric surgery.

Department to Visit

It is recommended to visit the Gastroenterology/Gastrointestinal-surgery department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.