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January 1967

Upper Gastrointestinal Hemorrhage: Undetected Site Localized by Selective Arteriography

Author Affiliations

From the divisions of diagnostic radiology and surgery, Montefiore Hospital and Medical Center, Bronx.

Arch Surg. 1967;94(1):44-45. doi:10.1001/archsurg.1967.01330070046012

SELECTIVE arteriography has been successfully used in the preoperative localization of gastrointestinal bleeding when conventional diagnostic modalities have failed.1 The following report emphasizes the value of this technique in a patient with uncontrollable upper gastrointestinal hemorrhage in whom neither a barium meal examination nor a subsequent laparotomy had established the site of bleeding.

Report of Case  A previously asymptomatic 55-year-old white woman was transferred to Montefiore Hospital with a ten-day history of vomiting coffee ground material, massive tarry stools, and a dropping hematocrit reading. Because of persistent severe gastrointestinal bleeding, the patient had been operated on at another hospital despite a negative gastrointestinal series. At laparotomy, blood was found from the midjejunum, distally, but no blood was found in the stomach or duodenum. The stomach and duodenum were opened widely, no bleeding point could be identified, and a pyloroplasty was done. The patient's hematocrit reading following postoperative transfusions rose

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