The purpose of this study was to compare the gross and histologic changes in the corpus and antrum in the rat hemorrhagic shock plus acid model of gastric injury, and to determine the effect of transfusion of shed blood or albumin on gastric lesion formation. The data indicate that (a) despite the gross appearance of more severe damage in the corpus, histologic damage was more severe in the antrum; (b) covering mucus and cell debris partly explain the difficulty in recognizing antral lesions grossly; (c) the severity of histologic injury was similar in transfused and nontransfused rats; and (d) transfusion of shed blood rendered corpus lesions more recognizable grossly but did not affect the severity of histologic injury. The latter findings raise questions about the pathogenetic importance of reperfusion in gastric ischemic injury and the validity of using gross lesions as an index of gastric injury.