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June 1950


Arch Surg. 1950;60(6):1076-1092. doi:10.1001/archsurg.1950.01250011101005

THE MANAGEMENT of patients with gross bleeding1 from the upper gastrointestinal tract has become a subject of renewed interest. It is difficult to obtain facts from the literature on this subject, because such hemorrhage can be of all degrees of severity and can occur from a variety of lesions and in various manners. Comparison of reports from different authors is therefore difficult. Yet it is obvious that a change is taking place among the members of the medical profession in their view of how these patients should be managed. There is also an encouraging trend of improvement in results.

SOURCE OF BLEEDING  Costello2 reported on 300 patients who vomited gross blood and had evidence of shock or anemia or both. Of these, 69.3 per cent bled from peptic ulcer, an additional 18 per cent from acute or chronic gastritis and 1.3 per cent from gastric carcinoma, a total