Upper Gastrointestinal Hemorrhage (and Portal Hypertension)

Abstract

During my residency in the 1980s, not a week passed without a few operations for bleeding duodenal (DU) or gastric (GU) ulcers. Emergency gastrectomies, antrectomies, truncal vagotomies, and highly selective vagotomies were our daily bread and butter. But, gradually things started to change. First appeared the H₂ antagonists, followed by proton pump inhibitors (PPIs), and then anti-Helicobacter therapy. In addition, novel methods of achieving transendoscopic hemostasis of bleeding ulcers emerged. As a result, at least where we practice, operations for upper gastrointestinal hemorrhage (UGI-H) have become a rarity, and our approach to them has been modified. However, if you work somewhere in the so-called developing world, where modern antiulcer medications are not freely available, you may be exposed still to the old pattern of peptic ulcer disease and the traditional methods of dealing with it.