Endoscopic features of a gastric ulcer

The endoscopic features of a gastric ulcer include:

• the majority are small, i.e. less than 2cm in diameter. Sometimes very large ulcers, up to 10 cm in diameter, may be seen in elderly patients.
• benign ulcers generally have a regular outline and appear to have been punched out of the gastric wall. Their base is often seen to contain a white slough. Malignant ulcers are more commonly found on the greater curve; their margins are 'heaped up.'
• the mucosa surrounding an ulcer is relatively normal - radiating folds may be present due to fibrotic contractures.
• the ulcer may have eroded through the stomach wall and through the lesser sac and be 'stuck' to the surface of the pancreas. In this case the floor or base of the ulcer is composed of pancreatic tissue.