Acute hemorrhagic gastritis in critically ill patient usually occurs in association with various physical stresses including sepsis, major operative procedures, severe traumas and burns. The lesions are always multiple and superficial. Rarely
penetration more deeply than muscularis mucosae and are without evidence of chronicity. The treatment is aimed at eliminating the underlying disease process if present, and contolling the hemorrhage.
Though it is known that medical tratment is preferred method of dealing with the hemorrhage, medical therapy is not always successful and surgery becomes necessary. Unfortunately, surgical treatment regardless of various surgical modalitites has
been
associated with a high mortality and with potential longterm morbidity.
Authors have analysed 118 cases of upper gastrointestinal bleeding due to acute hemorrhagic gastritis treated at the Department of Surgery, Busan National University Hospital from 1981 to 1990, and the results obtained were summerized as follows;
1) The age and sex incidence of acute hemorrhagic gastritis revealed greater prevalence in male with the ratio of 1.8 : 1, and more prominent in 5th decade(26.3%) and 4th decade(24.6%).
2) Single factors were 70.3%, among which major operative procedure was the most causative factor.
3) Medical treatment was successful at the 84 cases(71.2%). Antacid group and antacid with cimetidine group revealed similar results.
4) As surgical procedures, the results of bleeding control of truncal vagotomy with antrectomy were 60.0%, subtotal gastrectomy were 70.0%, truncal vagotomy with subtotal gastrectomy were 81.8% and total gastrectomy were 100.0%.
5) Overall mortality was 17.8%, and the surgical mortality was 41.2%, the relation between the stress factor and mortality revealed that multiple factors raised the mortality than signle factor.
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