<prompt> Treatment of choice of bleeding gastric ulcer:TV and drainageAntrectomyDistal gastrectomyUnder running of ulcer  <response>: MCC of UGI bleed non-variceal bleed 80 - Non-Variceal bleed; 20 - variceal bleed MCC of non-variceal UGI bleed Peptic ulcer MC site of Peptic ulcer Duodenum 1st pa Ulcer can be present on anterior or posterior wall of duodenum - Anterior wall ulcer - Perforate - Posterior wall ulcer - Bleed as gastroduodenal aery runs behind the posterior wall of duodenum MC aery involved in duodenal ulcer Gastroduodenal aery MC aery involved in Gastric ulcer Left gastric aery 1st investigation performed for UGI bleed Endoscopy both therapeutic and diagnostic Treatment for bleeding gastric ulcer: The principle of management of bleeding gastric ulcers are essentially the same. The stomach is opened at an appropriate position anteriorly and the vessel in the ulcer under-run. If the ulcer is not excised then a biopsy of the edge needs to be taken to exclude malignant transformation. Sometimes the bleeding is from the spienic aery and if there is a lot of fibrosis present then the operation may be challenging. However, most patients can be managed by conservative modality even if the incidence of recurrent bleeding is less-Bailey 27e page 1128 Treatment for bleeding Duodenal ulcer: - Duodenotomy; ligation of bleeding vessel; truncal vagotomy; pyloroplasty 