The patient remained stable overnight but required six units of packed red blood cells over that period.

The following morning the patient developed tachypnea and hypotension. He was intubated and placed on mechanical ventilation.

A repeat endoscopy revealed copious fresh blood and clots in the duodenum. He was taken urgently to the operating room where an antrectomy was performed.

Labs on admission:

	Antrectomy specimen:
	Close up of ulcer in antrectomy specimen:

1. What risk factors does this patient have for ulceration?

2. Describe the gross appearance of the ulcer.