Document Detail

Haematemesis and melaena, with special reference to factors influencing the outcome.
MedLine Citation:
PMID:  5440587     Owner:  NLM     Status:  MEDLINE    
In a study of 2,149 emergency admissions because of haematemesis or melaena during a 15-year period, the sex ratio, age distribution, and main diagnostic groups showed no major change. Various factors affected the prognosis, such as the age of the patient, the underlying diagnosis, a low blood pressure on arrival at hospital, gross anaemia on arrival there, and the pattern of bleeding after admission. The fatality rate remained virtually constant throughout the period studied in spite of changes in diagnostic methods and management. There was a changing pattern in the type of operation performed in the treatment of bleeding peptic ulcer. Vagotomy combined with a drainage procedure and with a direct surgical attack on the bleeding point became more widely used at the expense of Polya or Billroth I partial gastrectomy and gave the best results. It is at first paradoxical that improved surgical results should not be reflected in a general improvement in the fatality rate, but this finding can be explained by the smaller proportion of patients treated by emergency surgery in the later years of the period studied. It is concluded that emergency surgery should be performed more frequently and that vagotomy plus drainage is the operation of choice in the peptic ulcer group.
K F Schiller; S C Truelove; D G Williams
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British medical journal     Volume:  2     ISSN:  0007-1447     ISO Abbreviation:  Br Med J     Publication Date:  1970 Apr 
Date Detail:
Created Date:  1970-06-05     Completed Date:  1970-06-05     Revised Date:  2010-10-26    
Medline Journal Info:
Nlm Unique ID:  0372673     Medline TA:  Br Med J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  7-14     Citation Subset:  AIM; IM    
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MeSH Terms
Age Factors
Blood Group Antigens
Blood Transfusion
Esophageal and Gastric Varices / mortality
Hematemesis / etiology,  mortality*
Melena / etiology,  mortality*
Middle Aged
Peptic Ulcer Hemorrhage / mortality,  surgery
Stomach Neoplasms / mortality
Reg. No./Substance:
0/Blood Group Antigens

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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