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- W2139310792 abstract "T HE surgica1 literature is replete with information and guidance as to procedure in patients who have suffered massive gastric or duodenal hemorrhage. SubtotaI gastrectomy is advocated aImost universaIIy for patients over fift,v years of age who have sustained severe and repeated hemorrhage and for those in the younger age groups when it becomes apparent that the gastric or duodena1 bleeding cannot be controlled by medical management. However, there is almost no advice in the Iiterature as to the proper course of action when massive hemorrhage is encountered during the immediate period after gastrectomy. Rlassive postgastrectomy hemorrhage is a rare but dread complication occurring in a small number of patients anywhere from two days to two weeks after operation. It is a11 the more unfortunate since it comes at a time when the patient appears to be we11 on his way toward surgica1 recovery. Such a complication is a frightening experience not onIy to the patient but also to the surgeon who is shocked to discover that the operative procedure has faiIed to eradicate the gastrointestinal bIeeding. If the gastrectomy was done to control bleeding from a duodena1 ulcer and if the uIcer was left in situ when performing the operation, the cause of postoperative hemorrhage is not difficult to surmise. However, a thorough perusal of the Iiterature, as well as the author’s own experience, leads to the conclusion that bleeding from an ulcer Ieft in situ takes pIace only rareIy. Most of the reported cases deal with patients who bIeed after the surgical remova of the offending uIcer. In these instances the bleeding must be attributed to a patent vesse1 in the anastomotic suture Iine or in the vicinity of the duodena1 stump. Dodson reported two of Iog partiaI gastrectomies for peptic uIcer with postoperative bleeding from the anterior portion of the gastroenteric stoma. In both instances excessive bIood Ioss was prevented by prompt recognition of the condition and immediate operation. GIenn and Harrison reported that six of 3og patients upon whom gastric resection was carried out bIed postoperativeIy but the hemorrhage was not severe enough to cause a critical" @default.
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- W2139310792 date "1954-04-01" @default.
- W2139310792 modified "2023-09-26" @default.
- W2139310792 title "Severe hemorrhage after subtotal gastrectomy" @default.
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- W2139310792 doi "https://doi.org/10.1016/0002-9610(54)90432-8" @default.
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