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FURTHER OBSERVATIONS ON MASSIVE UPPER INTESTINAL HEMORRHAGE

CYRIL COSTELLO, M.D.
AMA Arch Surg. 1953;66(6):818-826. doi:10.1001/archsurg.1953.01260030838013.
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OF SERIOUS emergencies affecting the upper intestinal tract, massive hemorrhage remains an outstanding clinical challenge, not only because of its high mortality rate but also because of prevalent controversies concerning such basic principles of management as methods of diagnosis and desirability of feeding, transfusing, and operating. In a previous communication1 the results in a series of 300 consecutive cases at the St. Louis City Hospital were presented along with a plan of management adapted to a series of 73 later cases in which improvement in mortality rate had been achieved.

This present report is based upon an experience with a total of 199 cases of massive hemorrhage from the upper intestinal tract which have been studied at the St. Louis City Hospital from 1946 to 1951, inclusively. Massive hemorrhage has been defined as an acute blood loss from the upper intestine, resulting in shock and in a fall of

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