Massive Bleeding Due to Acute Hemorrhagic Gastritis

Twenty patients with massive bleeding from acute hemorrhagic gastritis were treated by a variety of operative procedures. The overall mortality was 55%. Wound morbidity was very high and has caused us to routinely employ a plastic wound protector, retention sutures, monofilament wire fascial sutures, and packing open the skin and subcutaneous tissue for delayed closure. Vagotomy combined with pyloroplasty or gastroenterostomy was completely ineffectual, as was lesser gastric resection with or without vagotomy. The best operative procedure in our hands was vagotomy and a high (85% to 90%) subtotal gastric resection. The tendency to procrastinate in these very ill poor-risk patients is condemned.