Primrose J N, Gledhill T, Quirke P, Johnston D
Br J Surg. 1986 Nov;73(11):920-2. doi: 10.1002/bjs.1800731125.
The source of massive haemorrhage from the stomach cannot always be identified even with the use of fibreoptic endoscopy and angiography. Six patients with massive, continuing, non-variceal haemorrhage from the stomach are described in whom total gastrectomy was eventually required. Three patients were shown to have bled from submucosal arteriovenous malformations, two from erosive gastritis and one from a vessel in an ulcer at the oesophagogastric junction. One patient died as a result of surgery and another died later of disseminated malignant disease. The functional results in the remaining patients were surprisingly good and rebleeding has not occurred. Total gastrectomy is a satisfactory 'last resort' treatment for life-threatening gastric haemorrhage for which no cause can be found.
即使使用纤维内镜检查和血管造影术，也并非总能确定胃部大出血的来源。本文描述了6例胃部大量持续性非静脉曲张性出血的患者，最终均需要进行全胃切除术。其中3例患者出血源自黏膜下动静脉畸形，2例源自糜烂性胃炎，1例源自食管胃交界处溃疡内的血管。1例患者死于手术，另1例后来死于播散性恶性疾病。其余患者的功能结果出奇地好，且未再出血。对于无法找到病因的危及生命的胃出血，全胃切除术是一种令人满意的“最后手段”治疗方法。
