Hemorrhagic gastritis: current concepts.

Hemorrhagic gastritis is a common cause of upper GI hemorrhage, in which the clinical course may vary from a mild, self-limited illness when associated with gastric irritants, to lifethreatening massive hemorrhage when associated with stress in critically ill patients. Treatment is based upon early endoscopic diagnosis, withdrawal of offending gastric irritants, intensive organ system support, and reduction of gastric acidity. Angiographic techniques and surgery are restricted to patients who fail these supportive measures, often after blood replacement beyond the usual criteria for operative intervention, usually in patients with stress. Newer pharmacologic and endoscopic therapeutic modalities are under evaluation and may help improve survival among patients with massive hemorrhage from stress ulcer.