Serpiginous gastric erosions caused by aspirin and other nonsteroidal antiinflammatory drugs.

Erosive gastritis is a common disease, but no etiologic significance has been attributed to the size or shape of these gastric erosions. However, in 12 cases of erosive gastritis caused by aspirin (nine) and other nonsteroidal antiinflammatory drugs (NSAIDs) (indomethacin, two; naproxen, one) double-contrast upper gastrointestinal studies revealed incomplete linear and/or serpiginous erosions in the stomach. In nine cases, these distinctive erosions were clustered focally in the body of the stomach, on or near the greater curvature. All but one patient were symptomatic (epigastric pain, eight; upper gastrointestinal bleeding, two; nausea and vomiting, one), and marked clinical improvement occurred within several days after withdrawal of the offending agent. This experience suggests that incomplete linear or serpiginous erosions, particularly along the greater curvature of the stomach, should be strongly suggestive of aspirin- or other NSAID-induced gastritis. If recent ingestion of these drugs is confirmed, withdrawal of the offending agent should lead to a rapid clinical response in these patients.