Intrinsic Gastroduodenal Lesions as Causative Factors of Hematemesis

Previous study1has revealed that intrinsic gastroduodenal lesions are responsible for approximately 90 per cent of all cases of hematemesis. Since hematemesis is usually produced by such lesions, it is justifiable to consider their diagnostic significance in detail, for an accurate diagnosis is highly desirable and is the key to eventual successful treatment. The outstanding factor of value in the differential diagnosis of such intrinsic lesions is the correlated consideration of (1) an accurately recorded and perused history and (2) laboratory studies, chiefly roentgenologic observations. Among intrinsic gastroduodenal lesions producing hematemesis, the most common are peptic ulcer and gastric carcinoma, while nonspecific inflammatory lesions, mucosal erosions, benign tumors, gastric syphilis and tuberculosis make up a small proportion of hemorrhagic lesions. This enumeration of some of the intrinsic gastroduodenal diseases producing hematemesis reveals that they are of almost equal medical and surgical significance, and, consequently, cooperative treatment is essential. It