In case upper GI bleed associated with stress gastritis all are true except:
Ans. (c) Surgery involves anterior gastrotomy with ligation of bleeding ulcers and superficial erosionsRef: Sabiston 19th Edition, Pages 1167-11685 Salient points for Stress gastritis/ Stress Ulcers:* Multiple superficial erosions are stress ulcers* Most common in fundus of stomach* Cushing and curling ulcers are stress ulcers. Cushing ulcer is due to increased acid but not curling ulcer.* Only presentation is bleeding* Medical management with PPI and H2 blockers are used to maintain the intragastric pH >5. But sometimes surgery may be needed to control the bleeding. (Anterior gastrotomy and ligate the bleeding vessel and also accompanied with TV with pylorplasty)