Mechanical gastritis as cause of upper gastrointestinal hemorrhage.

Mechanical gastritis is confirmed as one of the causes of upper gastrointestinal hemorrhage, which is created directly by retching and vomiting in a patient with an esophageal hiatal hernia. Five cases of mechanical gastritis are reported in this paper. The clinical presentation of mechanical gastritis and the Mallory-Weiss syndrome may mimic each other. Upper gastrointestinal endoscopy showed the gastric mucosa to be propelled into the esophagus during nausea. This mucosa showed erosions and superficial ulcerations. The mucosa appeared 'congested' at and just below the cardia. It is suggested that the friction and compression of the gastric mucosa prolapsing through a constriction ring of the diaphragm into the hiatal hernia during retching and vomiting may cause mechanical trauma to the gastric mucosa, resulting in gastritis, erosions, and hemorrhage.