Abstract
AS one of the more desperate of medical emergencies, torrential upper gastrointestinal hemorrhage demands close teamwork between several medical workers: clinicians, nurses, radiologists, laboratory technicians, electrocardiographers, blood bank personnel, and chaplains. Because each may have an urgent job very soon after the patient arrives on the medical scene, a prescribed plan of action for immediate treatment is required if confusion and inefficiency are to be avoided. On the other hand, the many clinical variables encountered among bleeding patients, particularly as they pertain to the preexisting base line medical situation, necessitate the most thoughtful individualization in the treatment of each patient. In upper gastrointestinal hemorrhage the bleeding source lies somewhere proximal to the third portion of the duodenum. Thus, by definition, the source of upper gastrointestinal hemorrhage may be reached by routine peroral panendoscopy. This is an especially important point: it explains why arteriography is ordinarily not employed for diagnosis, even
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