In case upper GI bleed associated with stress gastritis all are true except:
Ans. (c) Surgery involves anterior gastrotomy with ligation of bleeding ulcers and superficial erosionsRef: Sabiston 19th Edition, Pages 1167-11685 Salient points for Stress gastritis/ Stress Ulcers:* Multiple superficial erosions are stress ulcers* Most common in fundus of stomach* Cushing and curling ulcers are stress ulcers. Cushing ulcer is due to increased acid but not curling ulcer.* Only presentation is bleeding* Medical management with PPI and H2 blockers are used to maintain the intragastric pH >5. But sometimes surgery may be needed to control the bleeding. (Anterior gastrotomy and ligate the bleeding vessel and also accompanied with TV with pylorplasty)
Surgery should be done if transfusion requirements is >6 units.
Vagotomy may be added
Surgery involves anterior gastrotomy with ligation of bleeding ulcers and superficial erosions
Total gastrectomy is rarely indicated
Stomach & Duodenum