As pointed out by Camprodon et al, juxtacardial or type IV gastric ulcers occur infrequently. Although they do not describe the incidence, Camprodon et al reported 8 patients from a 6-year period. Ulcers in this location occur in the elderly, are usually large, are potentially malignant, and frequently present with bleeding or perforation. Their patients were elderly and presented emergently. This combination of factors makes the bleeding juxtacardial ulcer a clinical challenge.
Thompson JS. Transgastric Surgery for Posterior Juxtacardial Ulcers—Invited Critique. Arch Surg. 2003;138(7):762. doi:10.1001/archsurg.138.7.762