Gastric devascularization

Gastric devascularization has been reported to effectively control massive hemorrhage from stress related gastric mucosal injury with acceptable mortality and morbidity rates. Since this type of injury formation is partially based upon decreased gastric mucosal blood flow, the success of devascularization seems paradoxical. Thus, gastric devascularization was performed upon miniature swine and the gastric mucosal blood flow was serially measured in order to attempt to explain its efficacy. Total gastric mucosal blood flow decreased immediately, a maximum 36 per cent at 60 minutes. At three hours, gastric mucosal blood flow, although still significantly lowered (11 per cent), had begun a recovery that was total at one week. These results suggest that the efficacy of devascularization lies in its ability to modulate decreased gastric mucosal blood flow and, thereby, stop hemorrhage from established lesions. The rapid rebound of gastric mucosal blood flow to near normal levels prevents extension of the erosive process. These factors from the physiologic basis for the efficacy of gastric devascularization.