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Surgery
A 30 yr old male patient presented with massive haemetemesis. Upper GI endoscopy shows a 2x2 cm ulcer on the posterior aspect of the first pa of the duodenum. Bleeding vessel is seen, but could not be controlled endoscopically. Patient's pulse rate is 100, BP 110/70, Hb 10 gms% after blood transfusion. What will be the next line of management is:
IV pantoprazole
Paial gastrectomy including the bleeding segment
Duodenotomy, with ligation of bleeding vessel, truncal vagotomy with pyloroplasty
Duodenotomy, ligation of bleeding vessel with truncal vagotomy, antrectomy
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