Giant gastric ulcer

Summary 1. The authors' experience in 27 cases of giant gastric ulcers (craters larger than 3 cm. in diameter) is presented.2. In 8 patients, the diagnosis of malignancy was made before treatment was begun. Four proved to have malignant ulcers, and the other 4 benign ones.3. Of the 18 patients submitted to the therapeutic test, 5 healed their lesions after 8 weeks and the remainder after 2 and a half, 5, and 13 months, respectively.4. The only serious complication was hemorrhage.5. Pulmonary chronic emphysema was found in 6 patients.6. The authors believe that the large size of these ulcers is not a criterion of malignancy, and that these giant lesions may heal as well as the smaller ones, although they show an increased tendency to recurrence.7. The authors emphasize the importance of the so-called pseudotumoral gastric ulcer, which roentgenologically and/or gastroscopically, as well as macroscopically, has the appearance of an ulcerated cancer. The benign nature of the lesion is revealed only by histologic study. Four patients were inadvertently submitted to extensive surgery, and 3 died as a result of their operations.The studies described in this article were supported by grants from Jayme Torres and the Jockey Club of São Paulo.