The Results of the Conservative Treatment of Upper Gastro-Intestinal Bleeding

Abstract

Summary The cases of upper gastrointestinal bleeding admitted to St. Joseph Mercy Hospital during the ten year period 1938–1947 have been studied. There were 208 admissions of 181 patients. The etiology of the bleeding and the degree of bleeding have been tabulated. Peptic Ulcer accounted for 78 per cent of the cases. Conservative treatment consisting of feeding diets, anti-acids, antispasmodics and transfusions was used in all cases. Bleeding was controlled in all but 14 cases, 7 per cent of the total. In one case perforation occurred requiring emergency closure. In two cases gastric resection was done successfully on the eighth and fifteenth hospital day respectively because hemorrhage from an ulcer was uncontrolled. The other 12 cases died from hemorrhage. The diagnosis and clinical course of these cases are tabulated. It was noted that patients admitted with evidence of mild hemorrhage may at a later date exsanguinate. The mortality of this conservative treatment must be left up to the reader depending on his interpretation of the salvage possibilities of the fatal cases. The mortality could vary from 10 per cent to 2.4 per cent.