Surgical application of kaolin-impregnated gauze (Combat Gauze) in severe hemorrhagic gastritis.

摘要

Massive upper gastrointestinal hemorrhage secondary to stress gastritis is a rare but life-threatening complication of critical illness. Even with multimodal therapy, mortality can exceed 40 per cent. Aggressive resuscitation, correction of coagulopathy, and complete acid suppression is the primary treatment once endos-copy has excluded a focal bleeding site amenable to endoscopic or surgical control. When this fails, more invasive means of hemorrhage control are limited and include surgical or angioembolic devascularization and gastrectomy. We present a case of massive hemorrhage from stress gastritis that failed medical management and was treated with direct application of a new topical hemostatic agent designed for the field treatment of severe extremity hemorrhage.