A 25-year-old man is involved in an automobile accident with resultant injuries including bilateral closed femur fractures, left pulmonary contusion, and closed head injury. On post-injury day 4, significant upper gastrointestinal hemorrhage begins. Endoscopic examination reveals an area of confluent ulceration with bleeding in the gastric fundus. Endoscopic hemostasis fails. Appropriate immediate management includes:
Lavage of gastric contents with iced saline Urgent total gastrectomy Selective aerial infusion of vasopressin the left gastric aery Inseion of Sangstaken-Blakemore balloon