[Necrosis of the lesser curve of the stomach after proximal selective vagotomy].

Necrosis of lesser curve of stomach after proximal selective vagotomy is a specific but rare hazard of this operation. Anatomical and pathophysiological findings speak in favour of ischaemic pathogenesis, even if a peptic factor may exceptionally play a role in some cases. Local tissue trauma enhances the risk of later sloughing of lesser curve. Three own reported cases without fatality point out the importance of previous massive ulcer bleeding with hypovolemic shock and severe anaemia. Early recognition and immediate reoperation only may avoid an otherwise fatal course. Simple oversewing has proved successful in treating even large lesions. Careful, atraumatic technique of skeletonization and reperitonealization of lesser curve help to prevent this life threatening complication.