The problem of the bleeding peptic ulcer

Gordon‐Taylor, Gordon

doi:10.1002/bjs.1800259820

Cited by 30 publications

(7 citation statements)

References 11 publications

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“…Finsterer (1936) urged the importance of early operation where there was known ulceration and recurrent haemorrhage and was able to point to higher mortalities if operation was delayed. His views have been re-emphasized in Great Britain by Gordon-Taylor (1937), Tanner (1951), Ogilvie, Cardoe, and Bentley (1952), and Tibbs (1960). It is noteworthy, however, that physicians and surgeons who practice this sort of collaboration cannot bring the mortality figure much below 5 to 7%, and Avery Jones (1956) reporting a mortality of 7-7 % in 1,764 cases seen between 1941 and 1954, felt that further resort to surgery could not have reduced the figure.…”

Section: Discussion How Is Mortality From Peptic Ulcer Haemorrhagementioning

confidence: 99%

Haemorrhage from peptic ulcer treated by continuous intragastric milk drip and early generous feeding

Ashby¹,

Anderson²,

Peaston³

1963

Gut

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EDITORIAL SYNOPSIS Early feeding by means of an intragastric milk drip has been practised in a group of 425 patients admitted to a regional hospital with bleeding peptic ulcers. A low overall mortality of 4.9 % was achieved even though more than a quarter of the patients treated were more than 60 years old. The fallacies in comparing mortalities from gastrointestinal bleeding are discussed and the need for adequate blood transfusion, early diagnosis, and medico-surgical collaboration emphasized.

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Section: Discussion How Is Mortality From Peptic Ulcer Haemorrhagementioning

confidence: 99%

Haemorrhage from peptic ulcer treated by continuous intragastric milk drip and early generous feeding

Ashby¹,

Anderson²,

Peaston³

1963

Gut

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“…6 Controlled studies of early endoscopic diag-nosis have not shown that early diagnosis consistently leads to a reduction in mortality. Knowledge of the lesion leads to an appropriate and early response, which depends upon the cause of bleeding. '…”

Section: Early Diagnosis and Prognosis By Means Of Fibre-optic Endoscopymentioning

confidence: 99%

“…Knowledge of the lesion leads to an appropriate and early response, which depends upon the cause of bleeding. ' 6 Controlled studies of early endoscopic diag-nosis have not shown that early diagnosis consistently leads to a reduction in mortality. This may be due to inadequacies in other aspects of management, including the complications of delayed surgery and emergency endoscopy.…”

Section: Early Diagnosis and Prognosis By Means Of Fibre-optic Endoscopymentioning

confidence: 99%

Bleeding Ulcer: Timing and Technique in Surgical Management

Hunt

1986

Australian and New Zealand Journal of Surgery

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The individual surgeon's training, experience and flexibility are decisive factors in the successful recovery of patients after surgery for acute bleeding peptic ulcer. With planned management, careful preparation for surgery should be considered as of equal importance to surgical skill. Early diagnosis and exact resuscitation are the two most important aspects of a plan of treatment which anticipates the need for early surgery. In the past, patients were often referred late for surgery after significant blood loss and transfusion. Surgeons have endeavoured to define the cases that are likely to rebleed and prepare them promptly for surgery. Probably the best indications for early surgery are severe haemorrhage, reflected by shock on admission, an age of over 50 and active bleeding from the ulcer seen at diagnostic endoscopy. Prospective studies have shown a reduction in mortality from bleeding ulcer where policy requires early endoscopic diagnosis, exact resuscitation in the intensive care unit and early surgery in high risk cases.

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“…Nowadays we base our treatment on adequate blood transfusion, early surgery when it is required, adequate oral nutrition as soon as possible, avoidance of dehydration and rapid ambulation. Blood transfusion by drip was not available until 1935 (Marriott and Kekwick, 1935); surgery of serious bleeding had a very high mortality (about 30%) (Finsterer, 1939;Gordon Taylor, 1937), and the treatment consisted of complete immobilization and gastric 'rest'. Thus patients were confined rigidly to bed for weeks on end. They were starved and only a much reduced fluid intake was allowed.…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal Bleeding

2010

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The problem of the bleeding peptic ulcer

Cited by 30 publications

References 11 publications

Haemorrhage from peptic ulcer treated by continuous intragastric milk drip and early generous feeding

Haemorrhage from peptic ulcer treated by continuous intragastric milk drip and early generous feeding

Bleeding Ulcer: Timing and Technique in Surgical Management

Gastrointestinal Bleeding

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