Endoscopy in the management of gastric ulcer disease

The influence of endoscopy on the management of gastric ulcer disease during a three-year period was reviewed. A total of 265 endoscopies on 120 gastric ulcer patients were performed. 145 of these endoscopies were controls of ulcers primarily diagnosed as benign. At these controls 4 carcinomas were detected, all invasive. In all these cases the endoscopist had a suspicion of malignancy at the first endoscopy, although it was not verified histologically. This emphasizes the importance of the macroscopic appearance of the ulcer and of appropriately taken biopsies. All gastric cancers during the same period were reviewed, only 3.4% were classified as early. They were all diagnosed at the first endoscopy. There was a significant decrease in the number of operations on suspicion of malignancy compared with earlier periods when endoscopy was not a routine procedure.