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Opening

JOEL W. BAKER, M.D.

AMA Arch Surg. 1959;78(4):507-509.

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

Question.

—In an otherwise healthy patient with an established diagnosis of bleeding peptic ulcer, what, if any, are your indications for emergency operation for hemorrhage? What if the source of bleeding has not been established?

Answer.

—The prima-facie indication, of course, is evidence that proper measures short of surgery have not controlled the hemorrhage. Unfortunately, there is no reliable test to determine whether or not the patient is continuing to bleed. The man of average weight may lose as much as 1,500 cc. of blood, if protected in a reclining position, without visible evidence of shock. If he is allowed to stand, or if his trunk is tilted upward, as in fluoroscopy, shock may for the first time become evident. The best treatment when bleeding is initially seen is prompt and adequate blood transfusion, while at the same time the source of bleeding is being searched for. If, after adequate . . . [Full Text PDF of this Article]

Author Affiliations
Seattle

Footnotes
Submitted for publication June 26, 1958.

Read at a Panel Discussion before the Section on Gastroenterology and Proctology at the 107th Annual Meeting of the American Medical Association, San Francisco, June 26, 1958.

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