Mallory-Weiss Syndrome and Hypofibrinogenemia

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Abstract
SUDDEN uncontrollable bleeding is an alarming and frustrating hazard of surgery. When control is possible, it is by immediate recognition and modification of the cause that proves life saving to the patient. Report of a Case A 46-year-old white male with recurrent unceration at the anastomotic site of a gastroduodenostomy done six years previously following a Billroth I gastrectomy for bleeding was admitted to the hospital for surgical treatment. He was re-explored through an upper midline incision, and a 5 mm unceration was found perforating through the posterior inferior portion of the anastomotic site and into the pancreas. A bilateral vagectomy with a resection of 50% of the remaining stomach and freeing of the ulcerated anastomosis from the pancreas was done, the duodenum transected beyond this ulcer and closed, and a retrocolic gastrojejunostomy accomplished. As packs were removed prior to closure, the patient began to hiccup violently and repeatedly until

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