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SURGICAL MANAGEMENT OF MASSIVE HEMORRHAGE FROM PEPTIC ULCER

FRANK GLENN, M.D.; CHARLES S. HARRISON, M.D.
AMA Arch Surg. 1951;63(6):766-773. doi:10.1001/archsurg.1951.01250040782007.
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DURING the past 10 years the articles appearing in the medical literature on the subject of massive hemorrhage from peptic ulcer have been numerous, but rather contradictory.1 The policies advocated have ranged from nonoperative treatment regardless of circumstances to the opposite extreme of operation on all patients actively bleeding from a peptic ulcer. In 19462 Heuer reported the experience of this clinic with 337 patients admitted in a 14-year period (1932 to 1946) for massive hemorrhage believed due to a peptic ulcer. His review brought out the fact that the mortality rate for the group operated on immediately was only 10%, whereas for those operated on after hemorrhage for 48 hours or longer the mortality rate rose to 70%. He concluded that if operation was to save life it should be undertaken within 48 hours. He also stressed, however, that 288 of the 337 patients, or 85.5%, recovered

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