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May 1966

Gastric Hypothermia for Massive Upper Gastrointestinal Hemorrhage: Experience With 24 Patients and a Review of Literature

Author Affiliations

From the First University Surgical Service of the University Hospital, University of Washington School of Medicine, and the Third University Surgical Service of the Veterans Administration Hospital, Seattle.

Arch Surg. 1966;92(5):707-714. doi:10.1001/archsurg.1966.01320230055010

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

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