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February 1970

Stress Ulcers: A Clinical and Experimental Study Showing the Roles of Mucosal Susceptibility and Hypersecretion

Author Affiliations

From the Department of Surgery, State University of New York, Downstate Medical Center and Brooklyn Veterans Administration Hospital, Brooklyn.

Arch Surg. 1970;100(2):178-181. doi:10.1001/archsurg.1970.01340200066015

Upper-gastrointestinal tract bleeding or perforation, occurring during convalescence from operation or major illness, is frequently lethal. Incidence and mortality rise when the convalescence is stormy. Like steroid ulcers, stress ulcers occur without premonitory symptoms. The first sign of the stress ulcer is usually upper-gastrointestinal tract bleeding or perforation. Improved salvage from stress ulcers has not paralleled survival from the complications of peptic ulcer disease.

Massive bleeding and perforation are considered indications for surgery in complicated ulcer disease, yet conservative therapy is often recommended for stress ulcers, due to the complexity of the situations in which these ulcers arise. Because bleeding and perforation are life-threatening, proper therapy of stress ulcer is mandatory.

To establish support for clinical observations drawn from a series of 83 stress ulcers, an experimental model, using laboratory animals, was used (details of the experimental technique are described elsewhere).1 The results of the experiment successfully tested the

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