Pathoma Left Gastric artery in Ulcer

[MD22412]

So Pathoma states that since an ulcer most commonly occurs on the lesser curvature of the antrum, a complication is bleeding from the left gastric artery. Why is it the left gastric artery and not the right gastric artery (isn't the right the one that supplies the antral part)?

Also, complication of a posterior duodenal ulcer being rupture of the gastroduodenal artery. I don't get how you can pinpoint it to the gastroduodenal artery bleeding, when you also have the right gastroepiploic artery and supraduodenal artery or even superior pancreaticoduodenal arteries in the area.

Any idea how Sattar figures these complications for vessel rupture and how step 1 might test these?

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[abolt18]

Sattar doesn't just figure these things. They are the same in first aid (2014 pg 352), firecracker, and any other board review material. I imagine these are simply based on statistics of what is usually bleeding with a perforated ulcer.

 

[MD22412]

W/ neuroanatomy you can map precisely the nuclei each branch, eg AICA, serve. I don't get the lesser curvature of the antrum though. Is it because Left Gastric A is a branch off Celiac trunk, hence more blood whereas R gastric a is a branch off hepatic proper? That's the best I can come up with for that statistic you're saying.

 

[MD22412]

Or is it refferring to antrum of the cardia (top of the stomach?). I guess I always thought antrum mean the bottom right connecting to duodenum

 

[Transposony]

 

[fatwalletuab]

Goljan says right gastric artery, but FA and Pathoma says Left Gastric artery if the ulcer at the lesser curvature ruptures, anybody?any thoughts? i hope the question stem would not include those 2 on the answer choices, or they will specify if it's uppper lesser curvature or the part that's closer to the antrum

 

[syoung]

its probably left gastric, considering how large of a proportion of the lesser curvature is fed by the left gastric artery -> ulcer in the lesser curvature would cause bleeding by the left gastric artery