Early Diagnosis in Massive Gastrointestinal Hemorrhage

In the past, extensive efforts to achieve early diagnosis of the cause of massive upper gastrointestinal hemorrhage were limited by the fear of exacerbation of bleeding. In recent years, the wider use of prompt surgical intervention has been made possible by advances in surgical techniques, improved understanding of transfusion, and the greater availability of blood for this purpose. Since patients requiring emergency surgery must be differentiated promptly from those who should be treated without operation, the need for early accurate diagnosis of the cause of bleeding has been intensified. Diagnosis based on clinical grounds alone has proved unreliable in many instances; accordingly, we have employed adjuncts to early diagnosis during the past three years at the Boston City Hospital. Emergency roentgen examination of the upper gastrointestinal tract was performed on almost all the patients studied. In order to help differentiate patients with operable lesions such as peptic ulcer from those