<i  >Background</i>. Marginal ulcer is a well-known complication after gastrectomy. Its bleeding can be severe, but the severity has rarely been reported. We aim to evaluate the clinical outcomes of marginal ulcer bleeding (MUB) as compared to peptic ulcer bleeding (PUB) with nonoperated stomach. <i  >Methods</i>. A consecutive series of patients who had nonvariceal upper gastrointestinal bleeding and admitted to the hospital between 2005 and 2011 were retrospectively analyzed. A total of 530 patients were enrolled in this study, and we compared the clinical characteristics between 70 patients with MUB and 460 patients with PUB. <i  >Results</i>. Patients with MUB were older (mean age: <svg     style="vertical-align:-0.3003pt;width:90.6875px;" id="M1" height="11.4" version="1.1" viewBox="0 0 90.6875 11.4" width="90.6875"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.963)"><path id="x36" d="M137 343l67 33q37 17 63 17q79 0 129.5 -53t50.5 -131q0 -92 -58 -156.5t-147 -64.5t-147 68t-58 182q0 63 17 119t43 95.5t61.5 72t69 52t67.5 31.5q62 22 128 33l6 -32q-56 -11 -108 -35q-149 -71 -184 -231zM227 337q-47 0 -95 -27q-6 -23 -6 -70q0 -93 36 -155.5&#xA;t96 -62.5q53 0 78 45.5t25 105.5q0 68 -35 116t-99 48z" /></g><g transform="matrix(.017,-0,0,-.017,8.222,10.963)"><path id="x32" d="M412 140l28 -9q0 -2 -35 -131h-373v23q112 112 161 170q59 70 92 127t33 115q0 63 -31 98t-86 35q-75 0 -137 -93l-22 20l57 81q55 59 135 59q69 0 118.5 -46.5t49.5 -122.5q0 -62 -29.5 -114t-102.5 -130l-141 -149h186q42 0 58.5 10.5t38.5 56.5z" /></g><g transform="matrix(.017,-0,0,-.017,16.381,10.963)"><path id="x2E" d="M113 -12q-24 0 -39.5 16t-15.5 42q0 24 16 40.5t40 16.5t40 -16.5t16 -40.5q0 -26 -16 -42t-41 -16z" /></g><g transform="matrix(.017,-0,0,-.017,20.257,10.963)"><path id="x38" d="M249 635q70 0 116 -43t46 -105q0 -46 -28 -80q-22 -25 -80 -64q62 -35 97 -75t35 -99q0 -81 -63 -131t-135 -50q-83 0 -137.5 45.5t-54.5 123.5q0 52 45 95q29 28 89 64q-109 62 -109 155q0 66 50.5 115t128.5 49zM238 603q-42 0 -67.5 -31t-25.5 -72q0 -50 32.5 -79.5&#xA;t98.5 -62.5q61 48 61 124q0 59 -29.5 90t-69.5 31zM248 20q46 0 76.5 33.5t30.5 89.5q0 50 -39 85.5t-110 71.5q-81 -54 -81 -137q0 -67 35.5 -105t87.5 -38z" /></g><g transform="matrix(.017,-0,0,-.017,28.416,10.963)"><use xlink:href="#x36"/></g><g transform="matrix(.017,-0,0,-.017,40.35,10.963)"><path id="xB1" d="M535 290h-212v-206h-58v206h-213v50h213v193h58v-193h212v-50zM535 -22h-483v50h483v-50z" /></g><g transform="matrix(.017,-0,0,-.017,54.102,10.963)"><path id="x31" d="M384 0h-275v27q67 5 81.5 18.5t14.5 68.5v385q0 38 -7.5 47.5t-40.5 10.5l-48 2v24q85 15 178 52v-521q0 -55 14.5 -68.5t82.5 -18.5v-27z" /></g><g transform="matrix(.017,-0,0,-.017,62.261,10.963)"><path id="x30" d="M241 635q53 0 94 -28.5t63.5 -76t33.5 -102.5t11 -116q0 -58 -11 -112.5t-34 -103.5t-63.5 -78.5t-94.5 -29.5t-95 28t-64.5 75t-34.5 102.5t-11 118.5q0 58 11.5 112.5t34.5 103t64.5 78t95.5 29.5zM238 602q-32 0 -55.5 -25t-35.5 -68t-17.5 -91t-5.5 -105&#xA;q0 -76 10 -138.5t37 -107.5t69 -45q32 0 55.5 25t35.5 68.5t17.5 91.5t5.5 105t-5.5 105.5t-18 92t-36 68t-56.5 24.5z" /></g><g transform="matrix(.017,-0,0,-.017,70.42,10.963)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,74.296,10.963)"><path id="x35" d="M153 550l-26 -186q79 31 111 31q90 0 141.5 -51t51.5 -119q0 -93 -89 -166q-85 -69 -173 -71q-32 0 -61.5 11.5t-41.5 23.5q-18 17 -17 34q2 16 22 33q14 9 26 -1q61 -50 124 -50q60 0 93 43.5t33 104.5q0 69 -41.5 110t-121.5 41q-53 0 -102 -20l38 305h286l6 -8&#xA;l-26 -65h-233z" /></g><g transform="matrix(.017,-0,0,-.017,82.455,10.963)"><path id="x39" d="M244 635q90 0 143 -72t53 -177q0 -133 -65 -229.5t-171 -139.5q-79 -32 -140 -32l-5 30q109 18 185 91t101 186l-68 -36q-29 -16 -60 -16q-79 0 -129 51.5t-50 130.5q0 80 57 146.5t149 66.5zM228 602q-52 0 -78 -45.5t-26 -98.5q0 -69 36.5 -115.5t97.5 -46.5&#xA;q53 0 90 28q4 31 4 66q0 51 -9.5 95.5t-39 80.5t-75.5 36z" /></g>

		
	
</svg>
 years versus <svg     style="vertical-align:-0.3003pt;width:90.6875px;" id="M2" height="11.4" version="1.1" viewBox="0 0 90.6875 11.4" width="90.6875"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.963)"><use xlink:href="#x35"/></g><g transform="matrix(.017,-0,0,-.017,8.222,10.963)"><path id="x33" d="M285 378v-2q65 -13 102 -54.5t37 -97.5q0 -57 -30.5 -104.5t-74 -75t-85.5 -42t-72 -14.5q-31 0 -59.5 11t-40.5 23q-19 18 -16 36q1 16 23 33q13 10 24 0q58 -51 124 -51q55 0 88 40t33 112q0 64 -39 96.5t-88 32.5q-29 0 -64 -11l-6 29q77 25 118 57.5t41 84.5&#xA;q0 45 -26.5 69.5t-68.5 24.5q-67 0 -120 -79l-20 20l43 63q51 56 127 56h1q66 0 107 -37t41 -95q0 -42 -31 -71q-22 -23 -68 -54z" /></g><g transform="matrix(.017,-0,0,-.017,16.381,10.963)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,20.257,10.963)"><use xlink:href="#x33"/></g><g transform="matrix(.017,-0,0,-.017,28.416,10.963)"><use xlink:href="#x33"/></g><g transform="matrix(.017,-0,0,-.017,40.35,10.963)"><use xlink:href="#xB1"/></g><g transform="matrix(.017,-0,0,-.017,54.102,10.963)"><use xlink:href="#x31"/></g><g transform="matrix(.017,-0,0,-.017,62.261,10.963)"><use xlink:href="#x36"/></g><g transform="matrix(.017,-0,0,-.017,70.42,10.963)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,74.296,10.963)"><use xlink:href="#x36"/></g><g transform="matrix(.017,-0,0,-.017,82.455,10.963)"><use xlink:href="#x38"/></g>

		
	
</svg>
 years, <svg     style="vertical-align:-0.1638pt;width:58.712502px;" id="M3" height="11.375" version="1.1" viewBox="0 0 58.712502 11.375" width="58.712502"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><path id="x1D443" d="M619 482q0 -69 -40.5 -119t-96 -72.5t-118.5 -26.5h-44l-70 20l-31 -151q-14 -67 0.5 -83t89.5 -22l-5 -28h-287l8 28q65 7 81.5 22t29.5 83l79 398q12 56 0.5 70.5t-78.5 20.5l7 28h255q108 0 164 -43t56 -125zM524 478q0 141 -146 141q-25 0 -47 -8q-16 -6 -20.5 -13.5&#xA;t-10.5 -39.5l-43 -241q37 -13 83 -13q67 0 125.5 45t58.5 129z" /></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><path id="x3D" d="M535 323h-483v50h483v-50zM535 138h-483v50h483v-50z" /></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,38.446,11.112)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><use xlink:href="#x31"/></g>

		
	
</svg>). The initial hemoglobin was lower (<svg     style="vertical-align:-0.3003pt;width:74.362503px;" id="M4" height="11.4" version="1.1" viewBox="0 0 74.362503 11.4" width="74.362503"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.963)"><use xlink:href="#x38"/></g><g transform="matrix(.017,-0,0,-.017,8.222,10.963)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,12.098,10.963)"><use xlink:href="#x31"/></g><g transform="matrix(.017,-0,0,-.017,20.257,10.963)"><use xlink:href="#x36"/></g><g transform="matrix(.017,-0,0,-.017,32.19,10.963)"><use xlink:href="#xB1"/></g><g transform="matrix(.017,-0,0,-.017,45.942,10.963)"><use xlink:href="#x33"/></g><g transform="matrix(.017,-0,0,-.017,54.102,10.963)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,57.977,10.963)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,66.137,10.963)"><use xlink:href="#x35"/></g>

		
	
</svg>&#x2009;g/dL versus <svg     style="vertical-align:-0.3003pt;width:74.362503px;" id="M5" height="11.2875" version="1.1" viewBox="0 0 74.362503 11.2875" width="74.362503"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.862)"><use xlink:href="#x39"/></g><g transform="matrix(.017,-0,0,-.017,8.222,10.862)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,12.098,10.862)"><use xlink:href="#x33"/></g><g transform="matrix(.017,-0,0,-.017,20.257,10.862)"><use xlink:href="#x38"/></g><g transform="matrix(.017,-0,0,-.017,32.19,10.862)"><use xlink:href="#xB1"/></g><g transform="matrix(.017,-0,0,-.017,45.942,10.862)"><use xlink:href="#x32"/></g><g transform="matrix(.017,-0,0,-.017,54.102,10.862)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,57.977,10.862)"><path id="x34" d="M456 178h-96v-72q0 -51 12.5 -62.5t72.5 -16.5v-27h-256v27q65 5 78 17t13 62v72h-260v28q182 271 300 426h40v-407h96v-47zM280 225v295h-2q-107 -148 -196 -295h198z" /></g><g transform="matrix(.017,-0,0,-.017,66.137,10.862)"><use xlink:href="#x39"/></g>

		
	
</svg>&#x2009;g/dL, <svg     style="vertical-align:-0.1638pt;width:58.712502px;" id="M6" height="11.375" version="1.1" viewBox="0 0 58.712502 11.375" width="58.712502"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><use xlink:href="#x1D443"/></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,38.446,11.112)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><use xlink:href="#x31"/></g>

		
	
</svg>), and the duration of admission was longer in MUB (<svg     style="vertical-align:-0.3003pt;width:74.362503px;" id="M7" height="11.2875" version="1.1" viewBox="0 0 74.362503 11.2875" width="74.362503"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.862)"><path id="x37" d="M447 623l8 -12l-283 -613l-74 -10l-7 11q174 283 297 551h-216q-48 0 -62.5 -12t-33.5 -63h-29q10 60 18 148h382z" /></g><g transform="matrix(.017,-0,0,-.017,8.222,10.862)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,12.098,10.862)"><use xlink:href="#x31"/></g><g transform="matrix(.017,-0,0,-.017,20.257,10.862)"><use xlink:href="#x34"/></g><g transform="matrix(.017,-0,0,-.017,32.19,10.862)"><use xlink:href="#xB1"/></g><g transform="matrix(.017,-0,0,-.017,45.942,10.862)"><use xlink:href="#x34"/></g><g transform="matrix(.017,-0,0,-.017,54.102,10.862)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,57.977,10.862)"><use xlink:href="#x31"/></g><g transform="matrix(.017,-0,0,-.017,66.137,10.862)"><use xlink:href="#x30"/></g>

		
	
</svg> days versus <svg     style="vertical-align:-0.3003pt;width:74.362503px;" id="M8" height="11.2875" version="1.1" viewBox="0 0 74.362503 11.2875" width="74.362503"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,10.862)"><use xlink:href="#x35"/></g><g transform="matrix(.017,-0,0,-.017,8.222,10.862)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,12.098,10.862)"><use xlink:href="#x39"/></g><g transform="matrix(.017,-0,0,-.017,20.257,10.862)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,32.19,10.862)"><use xlink:href="#xB1"/></g><g transform="matrix(.017,-0,0,-.017,45.942,10.862)"><use xlink:href="#x32"/></g><g transform="matrix(.017,-0,0,-.017,54.102,10.862)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,57.977,10.862)"><use xlink:href="#x39"/></g><g transform="matrix(.017,-0,0,-.017,66.137,10.862)"><use xlink:href="#x37"/></g>

		
	
</svg>
 days, <svg     style="vertical-align:-0.1638pt;width:58.712502px;" id="M9" height="11.375" version="1.1" viewBox="0 0 58.712502 11.375" width="58.712502"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><use xlink:href="#x1D443"/></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,38.446,11.112)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><use xlink:href="#x33"/></g>

		
	
</svg>). After initial hemostasis, the rebleeding rate during admission was higher (16.2&#x25; versus 6.5&#x25;, <svg     style="vertical-align:-0.1638pt;width:58.712502px;" id="M10" height="11.375" version="1.1" viewBox="0 0 58.712502 11.375" width="58.712502"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><use xlink:href="#x1D443"/></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,38.446,11.112)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><use xlink:href="#x31"/></g>

		
	
</svg>) in MUB. However, the mortality rate did not differ statistically between MUB and PUB groups. <i  >Helicobacter pylori</i>-positive rate with MUB was lower than that of PUB (19.4&#x25; versus 54.4&#x25;, <svg     style="vertical-align:-0.1638pt;width:58.712502px;" id="M11" height="11.375" version="1.1" viewBox="0 0 58.712502 11.375" width="58.712502"  xmlns:xlink="http://www.w3.org/1999/xlink" xmlns="http://www.w3.org/2000/svg">
	
		
			<g transform="matrix(.017,-0,0,-.017,.062,11.112)"><use xlink:href="#x1D443"/></g><g transform="matrix(.017,-0,0,-.017,15.582,11.112)"><use xlink:href="#x3D"/></g><g transform="matrix(.017,-0,0,-.017,30.286,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,38.446,11.112)"><use xlink:href="#x2E"/></g><g transform="matrix(.017,-0,0,-.017,42.321,11.112)"><use xlink:href="#x30"/></g><g transform="matrix(.017,-0,0,-.017,50.481,11.112)"><use xlink:href="#x31"/></g>

		
	
</svg>). <i  >Conclusions</i>. Clinically, MUB after gastrectomy is more severe than PUB with nonoperated stomach. Infection with <i  >H. pylori</i> might not appear to play an important role in MUB after gastrectomy.

Woo Chul Chung

Eun Jung Jeon

Kang-Moon Lee

Chang Nyol Paik

You Suk Oh

Yang Woon Lee

Sang Bae Kim

Kyong-Hwa Jun

Hyung Min Chin

Clinical Outcomes of the Marginal Ulcer Bleeding after Gastrectomy: As Compared to the Peptic Ulcer Bleeding with Nonoperated Stomach

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Gastroenterology Research and Practice

Helicobacter pylori Infection and Upper Gastrointestinal Disorders

Helicobacter pylori Infection and Upper Gastrointestinal Disorders

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Clinical Outcomes of the Marginal Ulcer Bleeding after Gastrectomy: As Compared to the Peptic Ulcer Bleeding with Nonoperated Stomach