Stress ulcer: a continuing dilemma

The disease is painless and presents as a massive upper GI hemorrhage. Early diagnosis and rapid treatment are mandatory for patient survival. A variety of nonoperative treatment regimens are available, none demonstrating a clearcut superiority. Because the incidence of rebleeding is high, operative intervention is frequently required. The appropriate surgical procedure is unclear, although most surgeons perfer a generous subtotal gastrectomy with truncal vagotomy. Unquestionably, the best treatment is prevention.