Superficial gastric erosions: Response to surgical treatment

W. S. Wilson, T. Gadacz, C. Olcott, F. W. Blaisdell

Research output: Contribution to journalArticle

Abstract

The records of 56 patients who underwent surgery for hemorrhage from superficial gastric erosions were reviewed. Cases were divided into two groups of 28 each, depending on the predisposing factors. Group I patients with trauma, sepsis, and recent surgery; group II those with alcoholism, excessive aspirin intake, low cardiac output, diabetes, and idiopathic factors. The results of this study showed the following: there was no statistically significant difference in age between the two groups. Postoperative rebleeding rates did not differ significantly for the two groups. Of 21 patients who had vagotomy and drainage with systematic suture ligation of visible erosions, whether or not they were bleeding at gastrotomy, two (9.5%) had rebleeding. Of 19 patients who had vagotomy and drainage without suture ligation, 9 (47%) had rebleeding. When the rebleeding rates after these two procedures are compared, the difference is statistically significant (P <0.05). Of 9 patients with partial gastrectomy without vagotomy, 4 (44%) had rebleeding; one total gastrectomy resulted in death from sepsis. Rebleeding rates correlated well with the amount of blood transfused preoperatively. Mortality correlated better with the severity of the patient's illness prior to bleeding than with the operation performed. From a consideration of gastric physiology and mucosal microvascular anatomy, it is believed that bleeding occurs as a result of previous or recurrent episodes of mucosal ischemia and that vagotomy lessens the tendency to further erosion by decreasing the acid output in these stressed patients. Suture ligation is useful in preventing further venous hemorrhage from erosions already present.

Original languageEnglish (US)
Pages (from-to)133-140
Number of pages8
JournalAmerican Journal of Surgery
Volume126
Issue number2
StatePublished - 1973
Externally publishedYes

Fingerprint

Stomach
Vagotomy
Hemorrhage
Sutures
Ligation
Gastrectomy
Therapeutics
Drainage
Sepsis
Low Cardiac Output
Causality
Alcoholism
Aspirin
Anatomy
Ischemia
Acids
Mortality
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery

Cite this

Wilson, W. S., Gadacz, T., Olcott, C., & Blaisdell, F. W. (1973). Superficial gastric erosions: Response to surgical treatment. American Journal of Surgery, 126(2), 133-140.

Superficial gastric erosions : Response to surgical treatment. / Wilson, W. S.; Gadacz, T.; Olcott, C.; Blaisdell, F. W.

In: American Journal of Surgery, Vol. 126, No. 2, 1973, p. 133-140.

Research output: Contribution to journalArticle

Wilson, WS, Gadacz, T, Olcott, C & Blaisdell, FW 1973, 'Superficial gastric erosions: Response to surgical treatment', American Journal of Surgery, vol. 126, no. 2, pp. 133-140.
Wilson WS, Gadacz T, Olcott C, Blaisdell FW. Superficial gastric erosions: Response to surgical treatment. American Journal of Surgery. 1973;126(2):133-140.
Wilson, W. S. ; Gadacz, T. ; Olcott, C. ; Blaisdell, F. W. / Superficial gastric erosions : Response to surgical treatment. In: American Journal of Surgery. 1973 ; Vol. 126, No. 2. pp. 133-140.
@article{9182de1f1c7b46af901464bcb3757c73,
title = "Superficial gastric erosions: Response to surgical treatment",
abstract = "The records of 56 patients who underwent surgery for hemorrhage from superficial gastric erosions were reviewed. Cases were divided into two groups of 28 each, depending on the predisposing factors. Group I patients with trauma, sepsis, and recent surgery; group II those with alcoholism, excessive aspirin intake, low cardiac output, diabetes, and idiopathic factors. The results of this study showed the following: there was no statistically significant difference in age between the two groups. Postoperative rebleeding rates did not differ significantly for the two groups. Of 21 patients who had vagotomy and drainage with systematic suture ligation of visible erosions, whether or not they were bleeding at gastrotomy, two (9.5{\%}) had rebleeding. Of 19 patients who had vagotomy and drainage without suture ligation, 9 (47{\%}) had rebleeding. When the rebleeding rates after these two procedures are compared, the difference is statistically significant (P <0.05). Of 9 patients with partial gastrectomy without vagotomy, 4 (44{\%}) had rebleeding; one total gastrectomy resulted in death from sepsis. Rebleeding rates correlated well with the amount of blood transfused preoperatively. Mortality correlated better with the severity of the patient's illness prior to bleeding than with the operation performed. From a consideration of gastric physiology and mucosal microvascular anatomy, it is believed that bleeding occurs as a result of previous or recurrent episodes of mucosal ischemia and that vagotomy lessens the tendency to further erosion by decreasing the acid output in these stressed patients. Suture ligation is useful in preventing further venous hemorrhage from erosions already present.",
author = "Wilson, {W. S.} and T. Gadacz and C. Olcott and Blaisdell, {F. W.}",
year = "1973",
language = "English (US)",
volume = "126",
pages = "133--140",
journal = "American Journal of Surgery",
issn = "0002-9610",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Superficial gastric erosions

T2 - Response to surgical treatment

AU - Wilson, W. S.

AU - Gadacz, T.

AU - Olcott, C.

AU - Blaisdell, F. W.

PY - 1973

Y1 - 1973

N2 - The records of 56 patients who underwent surgery for hemorrhage from superficial gastric erosions were reviewed. Cases were divided into two groups of 28 each, depending on the predisposing factors. Group I patients with trauma, sepsis, and recent surgery; group II those with alcoholism, excessive aspirin intake, low cardiac output, diabetes, and idiopathic factors. The results of this study showed the following: there was no statistically significant difference in age between the two groups. Postoperative rebleeding rates did not differ significantly for the two groups. Of 21 patients who had vagotomy and drainage with systematic suture ligation of visible erosions, whether or not they were bleeding at gastrotomy, two (9.5%) had rebleeding. Of 19 patients who had vagotomy and drainage without suture ligation, 9 (47%) had rebleeding. When the rebleeding rates after these two procedures are compared, the difference is statistically significant (P <0.05). Of 9 patients with partial gastrectomy without vagotomy, 4 (44%) had rebleeding; one total gastrectomy resulted in death from sepsis. Rebleeding rates correlated well with the amount of blood transfused preoperatively. Mortality correlated better with the severity of the patient's illness prior to bleeding than with the operation performed. From a consideration of gastric physiology and mucosal microvascular anatomy, it is believed that bleeding occurs as a result of previous or recurrent episodes of mucosal ischemia and that vagotomy lessens the tendency to further erosion by decreasing the acid output in these stressed patients. Suture ligation is useful in preventing further venous hemorrhage from erosions already present.

AB - The records of 56 patients who underwent surgery for hemorrhage from superficial gastric erosions were reviewed. Cases were divided into two groups of 28 each, depending on the predisposing factors. Group I patients with trauma, sepsis, and recent surgery; group II those with alcoholism, excessive aspirin intake, low cardiac output, diabetes, and idiopathic factors. The results of this study showed the following: there was no statistically significant difference in age between the two groups. Postoperative rebleeding rates did not differ significantly for the two groups. Of 21 patients who had vagotomy and drainage with systematic suture ligation of visible erosions, whether or not they were bleeding at gastrotomy, two (9.5%) had rebleeding. Of 19 patients who had vagotomy and drainage without suture ligation, 9 (47%) had rebleeding. When the rebleeding rates after these two procedures are compared, the difference is statistically significant (P <0.05). Of 9 patients with partial gastrectomy without vagotomy, 4 (44%) had rebleeding; one total gastrectomy resulted in death from sepsis. Rebleeding rates correlated well with the amount of blood transfused preoperatively. Mortality correlated better with the severity of the patient's illness prior to bleeding than with the operation performed. From a consideration of gastric physiology and mucosal microvascular anatomy, it is believed that bleeding occurs as a result of previous or recurrent episodes of mucosal ischemia and that vagotomy lessens the tendency to further erosion by decreasing the acid output in these stressed patients. Suture ligation is useful in preventing further venous hemorrhage from erosions already present.

UR - http://www.scopus.com/inward/record.url?scp=0015839161&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0015839161&partnerID=8YFLogxK

M3 - Article

C2 - 4541763

AN - SCOPUS:0015839161

VL - 126

SP - 133

EP - 140

JO - American Journal of Surgery

JF - American Journal of Surgery

SN - 0002-9610

IS - 2

ER -