Severe gastrointestinal bleeding resulting in total gastrectomy in a patient with major burns--a case report

Total gastrectomy for benign diseases: a two-case report and literature review

Total gastrectomy may be indicated in treating extensive stomach malignancies. It is also the procedure of choice in controlling the intractable ulcer diathesis associated with non-beta islet cell tumors of the pancreas when pancreatic tumor or metastases cannot be controlled medically. Here we report two patients with benign gastric diseases, who were treated for total gastrectomy. In combination with our experiences and relative literatures, the indications of total gastrectomy for benign disease were summarized.

Massive bleeding from a Dieulafoy-like lesion of the rectum in a burns patient

Gastrointestinal haemorrhage is a rare but well-recognised complication of extensive burns, the site of haemorrhage usually being in the upper gastrointestinal tract. The case of an 18-year old female patient who developed sudden massive rectal bleeding 1 month after suffering 45% body surface area burns is presented. The source of the haemorrhage was a Dieulafoy-type lesion at the anorectal junction associated with mucosal ulceration, a cause of bleeding not previously described in a patient with major burns. Angiographic embolisation failed to control the haemorrhage and surgical arrest was required, following which the patient made a complete recovery with no recurrence of bleeding. Haemorrhage from the lower gastrointestinal tract is rarely associated with major burns but may be significant when it occurs. The aetiology is unclear but sepsis, mucosal ischaemia and ulceration may be implicated.