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Lawrence Norton, MD; Joseph Greer, MD; Ben Eiseman, MD

AMA Arch Surg. 1970;101(2):200-204.

Abstract
The problem of stress ulcer was studied clinically and in the laboratory. Ten of 19 patients comatose following severe cerebral trauma showed evidence of gastric acid hypersecretion within the first week posttrauma. Three of the ten bled briefly from presumed stress ulcer. Hypersecretion was reduced in three patients after administration of a parasympatholytic drug. Acid hypersecretion occurred both in patients with and without corticosteroid therapy. The "Cushing's ulcer" appears to differ from other forms of stress ulcer in having a higher incidence of associated gastric hyperacidity. Neostigmine bromide, pilocarpine hydrochloride, vitamin A, and phytohemagglutinin failed to stimulate mucus secretion when used topically in gastric pouches. The concept of a topical mucigogue for use in stress ulcer patients remains to be established.

Author Affiliations
Denver

From the departments of surgery, University of Colorado Medical School and Denver General Hospital, Denver.

Footnotes
Submitted for publication March 4, 1970.

Read before the 27th annual meeting of the Central Surgical Association, Detroit, Feb 27, 1970.

Reprint requests to Department of Surgery, Denver General Hospital, Denver 80204 (Dr. Eiseman).

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ABSTRACT