2024 Volume 66 Issue 7 Pages 1458-1464
A 66-year-old woman was referred to our hospital with unsteadiness, abdominal pain, and black tarry stools. Upper gastrointestinal endoscopy with insufflation revealed poor gastric wall extension and an ulcerative lesion measuring approximately 8 cm around the lesser curvature of the middle body of the stomach. A gastric ulcer with a gastrojejunal fistula was diagnosed because an opening in the jejunum was observed at the base of the gastric ulcer, and radiographic examination showed that the ulcer was connected to the upper jejunum. Histological findings showed that the ulcer was not malignant and was caused by Helicobacter pylori infection or administration of non-steroidal anti-inflammatory drugs. After conservative treatment, the ulcer was scarred, and only a gastrojejunal fistula remained, with no recurrence of the ulcer or symptoms. The presence of a gastrojejunal fistula should be considered when a large ulcerative lesion with poor gastric wall extension is observed on endoscopic insufflation.
