Abstract
Emergency endoscopy was performed on 120 consecutive patients with bleeding gastric ulcer, and endoscopic findings of ulcer base were correlated with prognosis. According to relative distribution of 'belag' (white or brownish white coat covering ulcer base) and coagula on ulcer base, ulcers were classified into four types, i. e., B (belag type), Bc (belag+coagula type), Cb (coagula + belag type) and C (coagula type). The present series consisted of 38 type B, 46 type Bc, 17 type Cb and 19 type C ulcers. In patients with type B and type Bc ulcers, bleeding recurred in 2 (5.3%) and 7 (15.2%) respectively, but none developed irreversible shock or underwent emergency operation. In type Cb ulcer patients, bleeding recurred in 10 out of 17, and one of them developed irreversible shock, and 3 patients underwent emergency operation. In 19 patients with type C ulcer, an incidence of rebleeding was extremely high (18 out of 19), and irreversible shock was observed in 11. Most of the rebleeders had to be subjected to emergency operation. Thus it is concluded that the present classification of ulcer base at emergency endoscopy may be a useful prognostic factor in bleeding gastric ulcer.
