Unusual complications of oesophageal ulcers.

Bleeding peptic ulcers of the oesophagus account for about 4% of admissions for acute upper gastrointestinal bleeding.1"2 Further bleeding during the same admission will occur in one-third of these patients.2 After resuscitation, patients should be given intensive anti-reflux treatment. The ulcer should be biopsied, although carcinoma rarely presents with acute bleeding.1'2 Recurrent bleeding or failure of the ulcer to heal are indications for surgery, but the threshold for advising elective surgery should be low for patients who have already demonstrated severe reflux disease with a life-threatening complication.