• Team management, with a team composed of representatives of the specialties of gastroenterology, hematology, surgery, radiology, and clinical laboratory services can provide the best treatment for the patient with gross gastrointestinal bleeding. Exact diagnosis, including the general condition of the patient, has shown that, while peptic ulcer is the most common cause of gastrointestinal bleeding, in 134 of 285 cases the site of hemorrhage occurred in other regions. Having a "bleeding team" available at all times to act in an advisory capacity appears to be the best approach in reducing the mortality of the bleeding patient, especially when he is admitted as an emergency case. While all patients should have an initial trial on medical management, those who continue to bleed or in whom bleeding recurs should be considered for prompt surgical intervention.
Wirts CW, Bodi T. MANAGEMENT OF HEMORRHAGING GASTRODUODENAL ULCER. JAMA. 1957;163(14):1229–1234. doi:10.1001/jama.1957.02970490027006
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