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July 9, 1973

Hemorrhagic Gastritis From Nonabsorbable Sutures

Author Affiliations

North Miami Beach, Fla

JAMA. 1973;225(2):178-179. doi:10.1001/jama.1973.03220290056026

To the Editor.—  A case of hemorrhagic gastritis, thought to be due to silk suture material protruding from a gastrectomy anastomosis, was diagnosed gastroscopically and treated surgically.

Report of a Case.—  On Jan 12, 1970, a 50-year-old housewife had a two-thirds subtotal gastrectomy with Billroth II gastrojejunostomy for chronic duodenal ulcer disease manifested by intractable abdominal pain, vomiting, roentgenographic duodenal bulb deformity, and peribulbar adhesions. All layers of the anastomosis were closed with silk sutures.During the ensuing 11 months four episodes of tarry stools were associated with epigastric and bilateral flank pains and recurring iron deficiency anemia. There was no history of associated salicylate or alcoholic beverage ingestion, and antacids gave no relief. On Dec 1, 1971, she had a two-day history of vomiting and tarry stools, and several weeks of abdominal pain; there was epigastric tenderness and guaiac "flash" positive tarry stool appeared on rectal digital examination.The