A 68-year-old woman has been diagnosed with a benign ulcer on the greater curvature of her stomach, 5 cm proximal to the antrum. After 3 months of standard medical therapy, she continues to have guaiac positive stool, anemia, and abdominal pain with failure of the ulcer to heal. Biopsies of the gastric ulcer have not identified a malignancy. The next step in management is which of the following?
Vagotomy with a gastric drainage procedure is less satisfactory in the treatment of primary gastric ulcer. Treatment of a gastric ulcer may include Paial gastrectomy with a gastro-duodenal anastomosis (Billroth I). Vagotomy is not necessary because gastric ulcers are usually not associated with acid hypersecretion. A gastric ulcer that fails to heal despite medical therapy should be excised
Treatment of the anemia and repeat all studies in 6 weeks
Endoscopy and bipolar electrocautery or laser photocoagulation of the gastric ulcer
Admission of the patient for total parenteral nutrition (TPN), treatment of anemia, and endoscopic therapy
Surgical intervention, including paial gastric resection
Stomach & Duodenum