Stomal (Anastomotic) Ulcer From an Internist's Viewpoint

Abstract

Bleeding from the upper gastrointestinal tract was the presenting symptom of stomal, or anastomotic, ulcer in 71 of this series of 137 cases seen over a period of more than 20 years. Ulcerlike pain was the next most common initial manifestation, occurring in 38. In five instances, retained sutures were visualized gastroscopically, up to 24 months after gastric surgery. In six cases, symptoms of gastric fistula were the first evidence of stomal ulcer. The interval between gastric surgery and discovery of stomal ulcer exceeded 10 years in more than 12 percent of these cases.