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Recurrent Massive Hemorrhage in Patients With Achlorhydria and Atrophic Gastritis

Recurrent Massive Hemorrhage in Patients With Achlorhydria and Atrophic Gastritis Abstract Hemorrhagic gastritis has been observed in association with many diseases and following ingestion of alcohol and aspirin.1,2 It was appreciated that erosive gastritis and bleeding could occur in the presence of achlorhydria. However, emphasis has been placed in recent years on the presence of acid as an essential factor in the pathogenesis of the bleeding.3 In this report, three patients are described with massive recurrent hemorrhagic gastritis, each of whom had severe atrophic gastritis and achlorhydria. Report of Cases Case 1. —A 73-year-old white man, a former brewery worker and chronic alcoholic was hospitalized repeatedly at the Boston City Hospital because of recurrent melena and anemia and hypotension. In addition, he had calcific aortic stenosis, cardiomegaly, atrial fibrillation and congestive heart failure, and cirrhosis of the liver. Several of the bleeding episodes were preceded by alcohol ingestion, while others were not, and two bouts of bleeding occurred during References 1. Jankelson, U.M.; Jankelson, I.R.; and Zamcheck, N.: Hemorrhagic (Erosive) Gastritis , Amer J Dig Dis 4:603-627, 1959.Crossref 2. Alvarez, A.S., and Summerskill, W.H.J.: Gastrointestinal Hemorrhage and Salicylates , Lancet 2:920-925, 1958.Crossref 3. Davenport, H.W.: Damage to the Gastric Mucosa: Effect of Salicylates and Stimulation , Gastroenterology 49:189-196, 1965. 4. Langman, M.J.S.; Hansky, J. H.; Drury, A.B.; and Avery Jones, F.: The Gastric Mucosa in Radiologically Negative Acute Gastrointestinal Bleeding , Gut 5:550-552, 1964.Crossref 5. Joske, R.A.; Finckh, E.S.; and Wood, I.J.: Gastric Biopsy , Quart J Med 24:269-294, 1955. 6. McCray, R.S.; Winawer, S.J.; Amir-Ahmadi, H.; Martin F.; and Zamcheck, N.: Prednisolone Treatment of Chronic Hemorrhagic Gastritis, abstracted , Clin Res 15:239, 1967. 7. Deutsch, E.; Todd, J.J.; and Hayward, R.M.; ACTH and Cortisone Therapy for Recurrent Massive Gastric Hemorrhage After Subtotal Gastrectomy , New Eng J Med 254:363-366, 1956.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Recurrent Massive Hemorrhage in Patients With Achlorhydria and Atrophic Gastritis

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References (9)

Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1967.00300030069013
Publisher site
See Article on Publisher Site

Abstract

Abstract Hemorrhagic gastritis has been observed in association with many diseases and following ingestion of alcohol and aspirin.1,2 It was appreciated that erosive gastritis and bleeding could occur in the presence of achlorhydria. However, emphasis has been placed in recent years on the presence of acid as an essential factor in the pathogenesis of the bleeding.3 In this report, three patients are described with massive recurrent hemorrhagic gastritis, each of whom had severe atrophic gastritis and achlorhydria. Report of Cases Case 1. —A 73-year-old white man, a former brewery worker and chronic alcoholic was hospitalized repeatedly at the Boston City Hospital because of recurrent melena and anemia and hypotension. In addition, he had calcific aortic stenosis, cardiomegaly, atrial fibrillation and congestive heart failure, and cirrhosis of the liver. Several of the bleeding episodes were preceded by alcohol ingestion, while others were not, and two bouts of bleeding occurred during References 1. Jankelson, U.M.; Jankelson, I.R.; and Zamcheck, N.: Hemorrhagic (Erosive) Gastritis , Amer J Dig Dis 4:603-627, 1959.Crossref 2. Alvarez, A.S., and Summerskill, W.H.J.: Gastrointestinal Hemorrhage and Salicylates , Lancet 2:920-925, 1958.Crossref 3. Davenport, H.W.: Damage to the Gastric Mucosa: Effect of Salicylates and Stimulation , Gastroenterology 49:189-196, 1965. 4. Langman, M.J.S.; Hansky, J. H.; Drury, A.B.; and Avery Jones, F.: The Gastric Mucosa in Radiologically Negative Acute Gastrointestinal Bleeding , Gut 5:550-552, 1964.Crossref 5. Joske, R.A.; Finckh, E.S.; and Wood, I.J.: Gastric Biopsy , Quart J Med 24:269-294, 1955. 6. McCray, R.S.; Winawer, S.J.; Amir-Ahmadi, H.; Martin F.; and Zamcheck, N.: Prednisolone Treatment of Chronic Hemorrhagic Gastritis, abstracted , Clin Res 15:239, 1967. 7. Deutsch, E.; Todd, J.J.; and Hayward, R.M.; ACTH and Cortisone Therapy for Recurrent Massive Gastric Hemorrhage After Subtotal Gastrectomy , New Eng J Med 254:363-366, 1956.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Sep 1, 1967

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