This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Cohn et al¹ concluded that ongoing diverticular bleeding after 4-unit blood transfusion requires subtotal colectomy without localization by angiography. Their conclusion was based on record review, including 4 successful subtotal colectomies, and on review of the literature. By the same devices, we reached the same conclusion in 1972.²

In 20 years of testing this hypothesis, I have learned that record and literature reviews are deceptive because they miss nondiverticular bleeds that, while actively bleeding, would have followed an algorithm to an inappropriate and failed operation. In a subsequent report,³ I excluded without details 22 patients who underwent transfusion for lower gastrointestinal tract bleeding, were studied, discharged with diagnoses of diverticulosis, and later proved to have bled from other sources. Ten cases exceeded the 4-unit threshold and might have had useless colectomies: 2 for missed varices, 2 for ulcers, 2 for atriovenous malformations with coagulopathy, 3 for colonic polyps, and 1 . . . [Full Text of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

International Medical Graduates
Boba et al.
Arch Surg 1998;133:1369-1370.
FULL TEXT