A maneuver for detection of the site of gastric hemorrhage.

AN ALL TOO COMMON experience in the emergency surgical treatment of upper gastrointestinal hemorrhage is failure to detect the origin of bleeding at the time of operation. During the last 10 years there has been a marked change in attitude toward therapy in this situation. Formerly, many surgeons advised and practiced blind subtotal gastrectomy with the expectation that many of the occult lesions would be located in the specimen. More recently, the advisability of searching for the lesion has been stressed, and various forms of gastrotomy have been employed. This report is presented in order to describe a technical maneuver which has been found useful for the detection of gastric lesions after other methods, including direct visualization with gastrotomy, have been unsuccessful. The procedure to be described consists of eversion of the stomach, which permits flattening of the rugal folds as well as detailed inspection of large areas of gastric mucosa.