[Hemorrhage from acute ulcers of gastric mucosa]

The work analyses the results of management of 429 patients with acute erosive-ulcerative gastritis in a specialized department. The most frequent causes are duodeno- or enterogastric reflux (24.7%), abuse of alcohol (23.6%), medication with mucosa irritating drugs (22.5%). Particular attention is drawn to gastritis of a reflux character which is dangerous not only because of recurrent bleeding but also because of the possibility of structural reorganization of the gastric mucosa leading to development of carcinoma. Attention is focused on the errors in nonoperative and surgical treatment and the need for taking into consideration the etiopathogenesis of acute ulcers. In ulcerations of a reflux character it is recommended that after bleeding is arrested by conservative measures, an operation for removal of the reflux is performed in a planned order. In the other cases, in emergency situations, deep stitching of the erosions with vagotomy and pyloroplasty must be resorted to. The author considers acute ulcers of the stomach to be a precancer marker and believes it necessary to register all patients for regular medical control.