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July 1932


Author Affiliations


From the Medical Service of the Lankenau Hospital.

Arch Intern Med (Chic). 1932;50(1):1-26. doi:10.1001/archinte.1932.00150140008001

Diffuse bleeding from the gastric mucosa is regarded as a relatively unimportant phenomenon and is rarely, if ever, considered in the bedside diagnosis of patients afflicted with hematemesis. When the patient vomits blood, the differential diagnosis, as a rule, takes into consideration the following possibilities:

The Most Common Causes of Gastric Hemorrhage 

  1. Neoplasms:

    • Carcinoma

    • Polypi

  2. Ulcers:

    • Acute

    • Subacute and progressive

    • Chronic

  3. Infections—Acute or Chronic (May cause either a local ulcer or a diffuse gastritis):

    1. Intra-abdominal (colitis, enteritis, gastritis)

      • appendicitis

      • disease of the biliary tract

      • tuberculosis

      • typhoid

    2. Extra-abdominal

      • scarlet fever

      • yellow fever

      • measles

      • cellulitis

      • pneumonia

      • diphtheria

      • endocarditis

    3. Disease of the upper respiratory tract

    4. Pelvic disease

    5. Alcoholism

  4. Systemic Diseases:

    1. Cardiovascular

      • heart failure

      • endocarditis

      • thromboses or emboli

      • hypertension

      • aneurysms

      • ruptured varices

        • esophagus

        • rectum and anus (especially)

    2. Blood dyscrasias

      • leukemia

      • the purpuras

    3. Renal disease

    4. Cirrhosis

    5. Syphilis

    6. Allergy (urticaria)

  5. Corrosion:

    • From ingestion of poisons, as chloride, iodine, lye, etc.