The American Journal of Digestive Diseases

, Volume 9, Issue 7, pp 447–458 | Cite as

Sources of bleeding in upper gastrointestinal hemorrhage: A re-evaluation

  • David Katz
  • Peter Douvres
  • Herbert Weisberg
  • Robert Charm
  • William McKinnon


Two hundred fifty consecutive patients admitted for upper gastrointestinal hemorrhage were examined by endoscopy within 24 hr. of admission. The technic proved safe and was tolerated well. One hundred twenty-seven diagnoses (50.8%) were established by endoscopy alone. The incidence of duodenal ulcer (20%) as the bleeding source was strikingly below the figure usually quoted. Erosive gastritis and esophageal varices were the bleeding sources in 20% and 17.2% respectively, while 22% remained undiagnosed.


Public Health Gastritis Duodenal Ulcer Gastrointestinal Hemorrhage Esophageal Varix 
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  1. 1.
    Atik, M., andSimeone, F. A. Massive gastrointestinal bleeding: Study of 296 patients at City Hospital of Cleveland.A. M. A. Arch. Surg. 69:355, 1954.Google Scholar
  2. 2.
    Brown, J. R., Meyers, S. G., Posch, J. L., andDeneen, O. Massive hemorrhage from the upper gastrointestinal tract.A. M. A. Arch. Surg. 61:767, 1950.Google Scholar
  3. 3.
    Berkowitz, D., Thompson, C. M., Sussman, I., andGambescia, J. M. Acute upper gastrointestinal hemorrhage: Rational approach to diagnosis and management.J. A. M. A. 160:1398, 1956.Google Scholar
  4. 4.
    Warthin, T. A., Ross, F. B., Baker, D. V., Jr., andWissing, E. Management of upper gastrointestinal hemorrhage.Ann. Intern. Med. 39:241, 1953.Google Scholar
  5. 5.
    Zimmerman, S. L., Engel, E. F., Lapidas, B., Bradley, E. A., andClaytor, H. Analysis of 200 admissions for massive upper gastrointestinal bleeding.Ann. Intern. Med. 45:653, 1956.Google Scholar
  6. 6.
    Palmer, E. D. Observations on the vigorous diagnostic approach to severe upper gastrointestinal hemorrhage.Ann. Intern. Med. 36:1484, 1952.Google Scholar
  7. 7.
    Palmer, E. D. Diagnosis of Upper Gastrointestinal Hemorrhage. Thomas, Springfield, Ill., 1961.Google Scholar
  8. 8.
    Jones, F. A. Hematemesis and melena, with special reference to causation and to the factors influencing the mortality from bleeding peptic ulcers.Gastroenterology 30:166, 1956.Google Scholar
  9. 9.
    Katz, D., Douvres, P., Weisberg, H., McKinnon, W., andGlass, G. B. J. Early endoscopic diagnosis of acute upper gastrointestinal hemorrhage: Demonstration of the relatively high incidence of erosions as a source of bleeding.J. A. M. A. 188:405, 1964.Google Scholar
  10. 10.
    Hirschowitz, B. I., Luketic, G. C., Balint, J. A., andFulton, W. F. Early fiberscope endoscopy for upper gastrointestinal bleeding.Am. J. Digest. Dis. 8:816, 1963.Google Scholar
  11. 11.
    Selesnick, S. Pharyngeal anesthesia for gastroscopy and esophagoscopy: A new simplified technique.Gastroenterology 17:515, 1951.Google Scholar
  12. 12.
    Katz, D., Friedman, E., andSelesnick, S. Endoscopy in acute upper gastrointestinal bleeding.Am. J. Digest. Dis. 3 (N.S.):734, 1958.Google Scholar
  13. 13.
    Scott, N. M., Jr. Experience with the “vigorous diagnostic approach” to upper gastrointestinal hemorrhage.Ann. Intern. Med. 51:89, 1959.Google Scholar
  14. 14.
    Smith, H. W. Esophagoscopy during active upper gastrointestinal hemorrhage.Connecticut M. J. 23:519, 1959.Google Scholar
  15. 15.
    Jones, F. A., andKellock, T. D., cited by Coghill, N. F., and Willcox, R. G. Fattors in the prognosis of bleeding chronic gastric and duodenal ulcers.Quart. J. Med. 29:575, 1960.Google Scholar
  16. 16.
    Burnett, W. An evaluation of the gastroduodenal fibrescope.Gut 3:361, 1962.Google Scholar
  17. 17.
    Vickers, F. N., andStanley, M. M. Aspirin gastritis: gastroduodenoscopic observations. Four case reports,Gastroenterology 44:419, 1963.Google Scholar
  18. 18.
    Roth, J. L., Valdes-Dapena, A., Pieses, P., andBuchman, E. Topical action of salicylates in gastrointestinal erosion and hemorrhage.Gastroenterology 44:146, 1963.Google Scholar
  19. 19.
    Brodie, D. A., Marshall, R. W., andMoreno, O. M. The effect of ulcerogenic drugs on gastric acidity in the rat with chronic fistula.Gastroenterology 43:675, 1962.Google Scholar
  20. 20.
    Bonfils, S., Rossi, G., Liefooghe, G., andLambling, A. “Ulcere” experimental de contrainte du rat blanc, I. Méthodes. Fréquence des lesions. Modifications par certains procèdes techniques et pharmacodynamiques.Rev. Franç. Etud. Clin. Biol. 4:146, 1959.Google Scholar
  21. 21.
    Brodie, D. A., andHanson, H. M. A study of the factors involved in the production of gastric ulcer by the restraint technique.Gastroenterology 38:353, 1960.Google Scholar
  22. 22.
    Polish, E., Brady, J. V., Mason, J. W., Thach, J. S., andNiemeck, W. Gastric contents and the occurrence of duodenal lesions in the rhesus monkey during avoidance behavior.Gastroenterology 43:193, 1962.Google Scholar
  23. 23.
    Deter, R. I., andLiebelt, R. A. The development of acute gastric ulcers in rats treated with gold thioglucose.Gastroenterology 43:575, 1962.Google Scholar
  24. 24.
    Ivy, A. C, Grossman, M. I., andBachrach, W. H. Peptic Ulcer. Blakiston, Philadelphia (now New York), 1950.Google Scholar
  25. 25.
    Greene, L., Weisberg, H., Katz, D., andDouvres, P. Divergences in the demonstration of collateral circulation and portal hypertension in liver disease by esophagoscopy, splenic pulp manometry and splenoportography.A.G.A. Ann. Meet. Abst. 44:830, 1963.Google Scholar

Copyright information

© Hoeber Medical Division • Harper & Row, Publishers, Incorporated 1964

Authors and Affiliations

  • David Katz
    • 1
  • Peter Douvres
    • 1
  • Herbert Weisberg
    • 1
  • Robert Charm
    • 1
  • William McKinnon
    • 1
  1. 1.From the Section of Gastroenterology, Department of Medicine, and the Department of SurgeryNew York Medical College-Metropolitan Medical CenterNew York

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