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December 5, 1953


JAMA. 1953;153(14):1287. doi:10.1001/jama.1953.02940310055015

Rappaport1 has brought into focus a perplexing problem in a way that should benefit many future patients with gastroduodenal hemorrhage. Although in some cases the source of the hemorrhage cannot be found, he is specially concerned with that group in whom lesions presumed to be the cause of the hemorrhage are detected by roentgenogram or gastroscopy and in whom at operation the surgeon is unable by palpation and inspection to detect any lesion. He presents five such case reports of patients in whom a first operation failed to reveal the suspected lesion and a second operation was necessitated by a persistence of symptoms. In two of these cases an adenocarcinoma was found. One patient died three months later and the other recovered and had no recurrence of the hemorrhage. One other patient was found to have a lymphosarcoma and died two years after the second operation. The two remaining