Benign greater curve gastric ulcer: the "sump-ulcer"

Twenty-six cases of greater curve gastric ulcers are presented, of which all but one were benign. There appears to have been an increased occurrence of benign greater curve gastric ulcers in our institution. By using a double contrast barium examination diagnostic accuracy was high, although endoscopy and biopsy are required for confirmation. Greater curve gastric ulcers were commonest in elderly patients with concomitant disease and a high intake or oral drugs, particularly analgesics, potassium chloride supplements and steroids. The constant location of the ulceration in the most dependent part of the stomach suggests a causal relationship with drug ingestion in these patients. The term "sump-ulcer" is suggested. A relatively high incidence of perforation and gastrocolic fistulae was found. It would appear that gastrocolic fistulae from benign peptic ulcer disease, previously thought to be excessively rare, are becoming more commonly recognized.