MASSIVE gastrointestinal bleeding causes dramatic signs and symptoms for the patient and presents a challenge to the internist, the surgeon, and the radiologist. The source of such bleeding often remains obscure to the very end, and the mortality is high. A review of available data from several centers shows considerable variation in the incidence of massive bleeding, in the source of the bleeding, and in the mortality resulting from it. In order to obtain information bearing on these variables, the records of patients admitted to City Hospital of Cleveland because of gastrointestinal bleeding between the years 1941 and 1951 inclusive were reviewed and analyzed.
DEFINITION
As emphasized by the work of Stewart1 and his associates, interpretation of data concerning massive gastrointestinal hemorrhage must be qualified by a definition of the term. Welch2 showed, for instance, that by taking a red blood cell count of 2,500,000 per cubic millimeter