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October 1950

MASSIVE HEMORRHAGE FROM THE UPPER GASTROINTESTINAL TRACT: A Study of Three Hundred and Twenty-Four Cases Observed at the Detroit Receiving Hospital Over a Nine Year Period

Author Affiliations

From the combined Surgical and Medical Services of Wayne University College of Medicine and the City of Detroit Receiving Hospital.

AMA Arch Surg. 1950;61(4):767-774. doi:10.1001/archsurg.1950.01250020773017

THE PURPOSE of the paper is (1) to report on the causes of massive hemorrhage from the upper gastrointestinal tract, (2) to outline methods of diagnostic procedure when confronted with such bleeding, (3) to discuss nonoperative management of bleeding peptic ulcer and factors effecting mortality of this condition, (4) to contrast the results of conservative and surgical treatment and (5) to outline the indications for surgical intervention in bleeding ulcer and discuss operations performed. Our conclusions are based on a study of all available patients and records in the City of Detroit Receiving Hospital from 1940 through 1948 in which the presenting symptom on admission was bleeding from the upper gastrointestinal tract.

CAUSES OF MASSIVE HEMORRHAGE IN OUR SERIES  Table 1 presents the causes for massive hemorrhage in our series. Peptic ulcer is the most frequent cause of massive hemorrhage and accounted for 76 per cent of

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