Morning Quiz ☕️ 

A 67-year-old man presents to the office with complaints of abdominal pain.

A trial of proton pump inhibitors (PPIs), started 5 weeks ago, failed to alleviate the pain.

The pain is described as dull, cramping, and worsens during meals.

• Medical history: Unremarkable.

• Physical examination: Normal, except for epigastric tenderness.

• Endoscopy findings: Reveals an eroding gastric ulcer in the proximal part of the greater curvature of the stomach, overlying a large pulsating artery.

Question:

Which of the following arteries is most likely visible in this case?

Options:

A. Common hepatic artery
B. Left gastric artery
C. Right gastroepiploic artery
D. Left gastroepiploic artery
E. Superior pancreaticoduodenal artery
F. Cystic artery
G. Gastroduodenal artery

Correct Answer 🎯: D. Left gastroepiploic artery

⚙️

Gastric Ulcer Development

⬇

Mucosal erosion in proximal greater curvature (unresponsive to PPIs → suggests

non-acid etiology)

Location-Specific Blood Supply

⬇

Greater curvature vascular supply:

Proximal ⅔: Left gastroepiploic artery (branch of splenic artery)

Distal ⅓: Right gastroepiploic artery (branch of gastroduodenal artery)

Ulcer Erosion into Artery

⬇

Submucosal artery exposure → Visible pulsation (high-pressure arterial bleed

risk)

Left gastroepiploic artery is largest in this region → Most likely erodedPain Mechanism

⬇

Meal-induced pain: ↑ Blood flow during digestion → Pressure on exposed artery

Differential Table ⚖️ 

(Due to the nature of the question , there is no rapid recall )

Stay Hungry, Stay Curious!

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Dr. Shoaib Ahmad