A 48-year-old man presents with massive haematemesis. Endoscopy shows a posterior wall duodenal ulcer with a visible vessel spurting blood. Which artery is most commonly responsible for haemorrhage from a posterior duodenal ulcer?

• A Left gastric artery
• B Splenic artery
• C Gastroduodenal artery ✓
• D Superior mesenteric artery

Explanation

The gastroduodenal artery runs behind the first part of the duodenum, so a posterior penetrating ulcer can erode directly into it, producing torrential bleeding. This anatomical relationship explains why posterior ulcers bleed while anterior ulcers perforate into the peritoneal cavity. The left gastric artery relates to lesser-curve gastric ulcers, not the duodenum. At surgery or angiography the gastroduodenal artery is the target for control.

Reference: Sabiston Textbook of Surgery, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.