A case of gastric ulcer with gastric mucosal bridge

Abstract

A 63-year-old male visited our hospital with chief complaint of epigastralgia and hematemesis. Emergency upper gastrointestinal endoscopy was performed that revealed giant hemorrhagic gastric ulcer from the lesser curvature of middle body to supra-angular region with mucosal bridge. He was admitted to our hospital and received intravenous injection of proton-pump inhibitor. Six days after admission the gastric ulcer became A2 stage and 13 days after the ulcer became healing stage but the mucosal bridge still remained. Forty-one days after admission, the ulcer became H2 stage and the mucosal bridge was disappeared.
Some cases of mucosal bridge in inflammatory bowel disease and in the esophagus after endoscopic injection sclerotherapy have been reported, but reports of gastric mucosal bridge in Japan are rare. In our case, the patient had experienced gastric ulcers of lesser curvature of middle body and supra-angular region one year before this admission. So we speculated that in this case the mucosal bridge was the result of the penetration of two ulcers of lesser curvature from middle body to supra-angu-lar region.