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KMID : 0371319740160120043
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Journal of the Korean Surgical Society
1974 Volume.16 No. 12 p.43 ~ p.52
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Clinical Review of Acute Gastric Mucosal Disease
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全泰俊/Cheun, Tae Jun
薛正泫/朴基一/金春奎/Seul, Jung Hyun/Park, Ki Il/Kim, Choon Kyu
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Abstract
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The Term "Acute Gastric Mucosal Disease (AGMD)" encompasses a group of acute gastroduodenal erosion which occur in response to stress engendered by such factors as lesion of central nervous system, thermal burns, major trauma, surgical operation, sepsis, anoxia and some kinds of drug therapy. So, such terms as "acute erosive gastritis "acute hemorrhagic gastritis" "Cushing ulcer" "Curling ulcer" "Stress ulcer" and "acute gastrointestinal focal necrosis syndrome (ACFNS)" have been employed. Because the cause of these acute superficial mucosal lesions remains poorly .defined it refer to them as "Acute Gastric Mucosal Disease (AGMD) which cause massive gastro-intestinal bleeding.
A total 24 cases of AGMD were clinically reviewed as compare with foreigners´ report who were admitted to Severance Hospital during six years from Aug´ 1968 to July´ 1974.
The following results were obtained:
(1) The sex and age incidence of AGMD revealed a greater prevalence in male(19. 7%) and 4th to 5th decades(62.5%).
(2) The precipitating-factors as AGMD were drug(5 cases), unknown factors(5 cases), emotional stress(4 cases), operation (3 cases), medical illness (3 cases), alcohol (2 cases), trauma(1 cases) and burn (1 case) in this order.
(3) Among 24 cases, 22 cases were operated and 2 cases were conservatively treated. The mortality rate for patients recieving surgical treatment were 40. 9% (9 cases), while for the conservatives were 50% (1 cases).
(4) 22 cases of operation and 1 case of gastro-fiberseopy, lesions were, located in the stomach in 22 cases and only one case coexisted AGMD in the stomach and pre-existing chronic peptic ulcer in the duodenum.
(5) The histologic examination was showed as the multiple foci of mocosal erosion involved in the muscularis mucosae layer. A single ulcer with surrounding mucosal erosin were present in 3 cases and superficial multiple ulcer or diffuse mucosal erosion were present in 20 cases.
(6) The type of operative procedures were sub-total gastrectomy (10 cases), vagotomy with pylorplasty (6 cases), vagotomy with hemi-gastrectomy (2 cases), total gastrectomy (1 case), and vagotomy with ligation (1 case) in this order.
The vagotomy with hemi-gastrectomy had lower mortality than sub-total gastrectomy or vagoto
my with pylorplasty.
(7) The over all mortality rate was 41.7% (10 cases).
(8) The post-operative complication were rebleeding (9 cases), hepatic failure (4 cases), sepsis (3 cases) and pulmonary complication (3 cases) which caused the death.
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