THE FUNDAMENTAL problem in the management of massive peptic ulcer hemorrhage has been to choose which patient will respond to medical management and which patient will require emergency surgical treatment. At present the most popular method of management consists of initial medical treatment with blood replacement, followed by prompt surgery if there is a recurrence of significant hemorrhage. Stewart1 has used the actual amount of hemorrhage itself as an indication for the necessity of surgical treatment. This of course eliminates the risk of a patient exsanguinating, but has the disadvantage of doing emergency gastrectomy for hemorrhage in a significant number of patients who would respond to adequate medical management. In our series of 150 cases of proved peptic ulcer with acute massive hemorrhage, 60 patients were successfully treated medically. The age of the patient with massive peptic ulcer hemorrhage has been used in the past2 as the principal
CASWELL HT, BURNETT WE, ROSEMOND GP, LAUBY VW. PENETRATING PEPTIC ULCER WITH MASSIVE HEMORRHAGE AS AN INDICATION FOR EMERGENCY GASTRECTOMY: Method of Clinical Diagnosis. AMA Arch Surg. 1954;68(3):282–285. doi:10.1001/archsurg.1954.01260050284003
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