Gastric Ulcers Size and Characteristics

Most gastric ulcers are relatively small, with over half of patients having ulcers less than 2 cm in diameter. Ulcers larger than 2.5 cm are classified as giant ulcers, which tend to heal more slowly and may carry a higher risk of malignancy.

When dealing with giant ulcers, a biopsy is often necessary for accurate diagnosis. It's especially effective to take biopsy samples from the ulcer's edges or areas with tissue proliferation, as these locations have a higher likelihood of revealing abnormal cells.

Endoscopic evaluation plays a crucial role in determining whether an ulcer might be malignant. Certain features should raise suspicion of cancerous changes, such as an uneven ulcer base, presence of necrotic tissue, bleeding, or a dirty coating on the surface. Additionally, ulcers with nodular elevations around the perimeter, stiffness, irregularity, serrated appearance, or resembling a volcanic rim warrant particular attention.

To rule out malignancy, a biopsy must be performed when these suspicious characteristics are observed during endoscopic examination. Early detection and proper assessment are vital for effective treatment planning and patient outcomes.