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March 1968

Occult Gastrointestinal Hemorrhage in Burned Patients

Author Affiliations

Ann Arbor, Mich
From the Department of Surgery, University of Michigan Medical Center, Ann Arbor, Mich.

Arch Surg. 1968;96(3):420-422. doi:10.1001/archsurg.1968.01330210098019

ONE of the most dread complications of the management of the burned patient is gastrointestinal hemorrhage. An accurate evaluation of the incidence of this complication, also known as Curling's ulcer, is difficult. Hummel1 at the Brooke Army Hospital reported in 1957 a 2%20 incidence of Curling's ulcer in 1,000 consecutive burns (primarily adult males.) Choudhury2 reported in 1963 an 0.09% (2) incidence of Curling's ulcer in 2,165 burned children. In 1938 Harkins3 reported an incidence of 3.8% (26) in 680 necropsied burn cases. At the University of Michigan Medical Center, 340 burned patients were admitted from July 1, 1959, to Dec 31, 1965, and of these 2.6% (9) developed a Curling's ulcer (unpublished data).

On several occasions it has been noted that the number of blood transfusions necessary to keep the hematocrit at a level of 40% is greater than that which would appear to be

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