Gross hemorrhage as a complication of peptic ulcer

Abstract

1. The mortality rate from hemorrhage due to peptic ulcer shows an apparent increase in the last decade. 2. During this period we have observed no hemorrhage deaths in females. 3. In this same interval we have not seen any hemorrhage deaths in either sex from anastomotic ulcer. 4. There have been no deaths from hemorrhage in persons under thirty-five years of age. 5. Prognostically, 45 years seems the critical age for both the medical and the surgical treatment of hemorrhage; the mortality increases very rapidly after middle-life when arteriosclerosis presumably becomes a factor. 6. The restricted use of moderate transfusion is urged. The profligate use of large transfusions is criticized. 7. Our experience with the Meulengracht diet has not been encouraging; starvation in the early period is still preferred. 8. The problem of avitaminosis C, in respect to hemorrhage, requires further study. 9. The significance of urea estimation as a prognostic guide during hemorrhage is not convincing. 10. Surgical mortality in the treatment of hemorrhage, both immediate and shortly after the onset of hemorrhage, is still so high as to discourage its use in any but the most critical situations.