MASSIVE UPPER GASTROINTESTINAL HEMORRHAGE

概要

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Massive upper gastrointestinal hemorrhage is a frequent occurrence in almost any hospital setting. Because the patients affected are often chronically ill, and because of the serious physiologic consequences of massive bleeding, the surgeon must be prepared to treat all of the associated problems which may arise. There are well established "rules" which help decide when an operation is indicated. Once this point has been reached, a careful and thorough exploratory laparotomy can identify the source of bleeding, even if a preoperative diagnosis is not available. The role of gastrointestinal endoscopy is still controversial ; it is best viewed as a valuable adjunct in the aggressive evaluation of patients with bleeding, and an important part of a comprehensive treatment program. Endoscopic diagnosis must be combined with surgical judgment in treating the individual patient. Operative therapy is tailored to the patient and to the bleeding lesion. There is a general tendency to avoid resection, or resect "less" when possible, to avoid the prohibitive mortality generally associated with massive resection. By attention to the many details associated with gastrointestinal hemorrhage. The morbidity of a bleeding episode can be reduced. One must be aware of the high mortality in most series of patients with bleeding and do everything possible to prevent it.
一般社団法人日本消化器外科学会の論文
1981-08-01