MASSIVE upper gastrointestinal hemorrhage continues to be a serious problem encountered in our aging population. Frequently the bleeding cannot be controlled even by intensive conservative therapy which necessitates an emergency operation on a critically ill patient. Sometimes in the case of severe hemorrhage, an operation must be performed before an accurate diagnosis can be made. Numerous investigators have reported a high mortality for any operation performed under these circumstances. Darin et al observed that 44% of 291 patients with massive hemorrhage caused by peptic ulcer disease required such an emergency operation, with an overall surgical mortality of 25%; the highest mortality occurred in recurrent bleeders and those with the greatest rapid blood loss.1 In another report, Foster et al described a 28% overall operative mortality for emergency gastroduodenal surgery in the bleeding patient which, in fact, increased to 63% for those patients whose massive upper gastrointestinal hemorrhage began while
SCHALLER RT, HESSEL EA, KING LT, STEVENSON JK. Gastric Hypothermia for Massive Upper Gastrointestinal Hemorrhage: Experience With 24 Patients and a Review of Literature. Arch Surg. 1966;92(5):707–714. doi:10.1001/archsurg.1966.01320230055010
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