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January 1954

MASSIVE HEMORRHAGE FROM GASTRIC ULCER ERODING GALL BLADDER AND ANOMALOUS CYSTIC ARTERY

Author Affiliations

CHARLESTON, S. C.
From the Departments of Surgery and Medicine, Medical College of the State of South Carolina, and the Roper Hospital.

AMA Arch Surg. 1954;68(1):120-125. doi:10.1001/archsurg.1954.01260050122016
Abstract

IN THE last decade, surgeons have focused their attention increasingly on the problems concerned with management of cases with severe bleeding from gastric ulcer. Stewart,1 Finsterer,2 and others have adopted the attitude that any patient with massive bleeding from ulcer of the stomach and duodenum should be subjected to emergency operation, while Andresen,3 Meulengracht,4 and their adherents prefer nonoperative therapy in all such cases. As a matter of routine, we have chosen a middle ground, feeling that each patient with massive hemorrhage from ulcer should be followed closely by both internist and surgeon, with an initial trial of conservative treatment. Like Dunphy and Hoerr,5 we attempt to select early in the course of the bleeding those patients who have the so-called fatal type of hemorrhage, and to advise emergency operation for these patients only. This selection is taxing to the best clinical judgment, and the

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