Control of Acute Gastric Mucosal Hemorrhage

During a 23-month period, 50 patients with acute unremitting gastric mucosal hemorrhage underwent angiography. Posterior pituitary extract was selectively infused into the bleeding artery in 37 of these patients, and the hemorrhage was angiographically and clinically controlled in 31 (84 per cent). Four of six patients whose bleeding was not controlled required an operation. The remaining 13 of the 50 patients were not infused with posterior pituitary extract, because in eight of them it was not technically feasible to catheterize the appropriate artery, and in five, associated conditions precluded therapy. Ten of these 13 patients required an operation to arrest bleeding. Of the 31 patients whose hemorrhage was controlled with the intra-arterial infusion of posterior pituitary extract, rebleeding occurred in two — in one seven days after the infusion and in the other 19 days after initial control and four days after a portacaval shunt. In no patient was it necessary to discontinue the infusion because of local or systemic complications. (N Engl J Med 290:597–603, 1974)