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We endoscopically investigated gastric microcirculation using a laser-Doppler flowmeter and acute gastric mucosal lesions (AGML) during a 3-year follow-up period in patients with hepatic cirrhosis. Gastric microcirculation tends to decrease in patients with hepatic cirrhosis, especially when gastric mucosal hemorrhage or mucosal petechiae are observed endoscopically. Total gastric resection was performed for gastric hemorrhage due to AGML in three patients, two of whom had good liver function--Child's grade A--and survived more than 5 years with a good quality of life, but one patient with Child's grade C experienced poor quality of life and died within 2 years after surgery. We conclude that decreased gastric microcirculation plays a role in the occurrence of AGML in patients with hepatic cirrhosis. Total gastric resection should be carefully considered for hemorrhagic gastritis in patients with Child's grade C hepatic cirrhosis.
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