Surgical Considerations in Hemorrhage of the Upper Part of the Gastrointestinal Tract

THE OCCURRENCE of massive hemorrhage from the stomach or the upper part of the small bowel presents a difficult problem to the clinician. A diagnostic problem is immediately presented because of the great variety of conditions which may produce such bleeding. A therapeutic problem is raised because of the lack of specific measures available for control of such hemorrhage and because of the existing differences of opinion regarding the proper treatment. The existence of differences of opinion regarding the treatment of hemorrhage from the upper part of the gastrointestinal tract, especially in regard to the indications for surgical intervention in patients with bleeding peptic ulcer, has prompted us to report our experience with cases in a large charity institution. MATERIAL A total of 305 patients was studied, who entered the Cook County Hospital because of gross melena, hematemesis or both. These patients were admitted during the three year period from