[Regeneration of the gastric mucosa under conditions of massive blood loss]

The autoradiographic method was used for a comparative study of regeneration of the gastric mucosa after wounding the rat with a preliminary loss of blood and without it. The H3-thymidin label index was determined in the portions of the mucosa of the wound edge and far from it. A histological analysis of healing the wounds failed to reveal any difference in terms of this process in rats with a loss of blood and without it. A momentary massive loss of blood did not influence the strain and intracellular regeneration processes in the healing wound of the stomach: the amount of cells synthesizing DNA at the edges of the gastrotonic wound proved to be the same in experiments both with a loss of blood and without it. The authors believe that it may serve as an indirect evidence of a somewhat exaggerated danger of surgery at the height of gastroduodenal bleeding.

[Bone marrow reaction to surgical intervention in gastroduodenal hemorrhage]

Experimentally and clinically, the authors have studied the effect of massive blood loss and various operative procedures (Billroth I and Hofmeister-Finsterer gastrectomies, pyloroplasty with vagotomy) on the hemopietic system. It has been found that the bone marrow response was mainly dependent on blood loss. A surgical intervention renders but insignificant effect on hemopoiesis, similar to that of a moderate hemorrhage, the character of an operative procedure being of no improtance.

Comparative study between endoscopy and radiology in acute upper gastrointestinal haemorrhage

A total of 158 patients with acute upper gastrointestinal haemorrhage were studied, and the 53 patients on whom emergency endoscopies were performed were compared with the remaining 105. The cause of the bleeding was found in 51 of the endoscopy group and 39 of the control group. Three patients in the endoscopy group and 16 controls died. In the endoscopy group the correct preoperative diagnosis was made in all cases and there was less delay before operation. In the control group five patients had no diagnosis before operation, the preoperative diagnosis was wrong in nine, and five had laparotomies during which no cause of bleeding was found. The patients in the endoscopy group who did not have operations had a shorter stay in hospital than the controls.