Erosive gastritis: Its Diagnosis, Management, and surgical treatment

Abstract

Abstract Three hundred and thirty-one patients with severe haemorrhage resulting from erosive gastritis, representing 10 per cent of 3938 patients admitted with severe gastroduodenal bleeding during the past 30 years, are presented. The problems of diagnosis and management are discussed; particularly, the role of immediáte gastroscopy and the indications for surgical treatment and the surgical procedure best designed to control the haemorrhage. Forty-seven patients required 51 emergency surgical procedures, and it was found that the Billroth-I gastrectomy was far superior to any other operation. Polya gastrectomy, vagotomy, and gastric vasoligation were used, with a high incidence of recurrent bleeding and often necessitating a further emergency surgical operation—usually total gastrectomy. It is suggested that a possible explanation of this is the prevention of biliary reflux into the stomach, which is what the Billroth-I gastrectomy seems to achieve. In 1 case presented, a patient with a Polya gastrectomy and erosions who had severe haemorrhage, bleeding was controlled by conversion to a Billroth-I anastomosis.