Management of peptic ulcer hemorrhage

Conclusions

• 1. Conservative medical therapy is the procedure of choice in treating bleeding ulcers.

• 2. Reservation should be practiced in accepting Meulengracht’s immediate feeding of patients with active bleeding.

• 3. Aluminum hydroxide offers an approach to attaining physiological control of a bleeding ulcer. It has a favorable place in our case report.

• 4. Transfusions by the direct method can be given safely without worry over elevated venous pressure, arterial pressure or any systemic reaction of significance.

• 5. Vitamins have an undetermined position in bleeding ulcer therapy.

• 6. We would not feed our bleeding ulcer cases immediately but would institute continuous aluminum hydroxide drip, a dietary regimen to be started when hemorrhage had ceased and sufficient time had elapsed for clot fibrosis. We feel that parenteral fluids should be given freely to maintain nutrition, water balance, circulating volume and to combat acidosis. Until proven otherwise synthetic Vitamin C will be considered a valuable adjunct to our regimen.