Bleeding from a duodenal ulcer almost always arises from either the superior or the inferior pancreaticoduodenal artery as they enter the scarred, noncontractile base of the ulcer. When an emergency operation is undertaken for continuing bleeding, the hemorrhage into the bowel may be so severe as even to be fatal while the operation is in progress, before the ulcerated portion of the bowel can be dissected free from the open, bleeding vessel, or even before the bleeding vessel can be transfixed.
A method is presented which has proved of great value in controlling the hemorrhage immediately after the laparotomy incision has been made. This method consists in applying a rubber- or linen-shod clamp across the duodenum just distal to the area of ulceration and another similar clamp across the stomach just proximal to the pylorus.
Any further hemorrhage which may arise from the bleeding vessel is then confined to this
TRIMBLE IR. A Method for the Immediate Control of Hemorrhage from Duodenal Ulcer at Operation. AMA Arch Surg. 1957;74(4):647-648. doi:10.1001/archsurg.1957.01280100165029