Experiences with surgical management of acute gastric mucosal hemorrhage: a unified concept in the pathophysiology

Images

Measurement of blood and iron loss in colitis with a whole-body counter

Estimation with a whole-body counter of the fall in total body radioactivity due to loss of parenterally administered (59)Fe has been used to measure blood loss in 17 patients with ulcerative colitis. It was shown that blood loss was related to the activity of disease as judged by sigmoidoscopic changes and less obviously to the extent of involvement of the colon. Blood losses of 50 to 150 ml per week were observed when the patient saw no blood in the stools and the rectal mucosa did not appear haemorrhagic. Some patients lost more than 0.5 g iron during the few weeks following an exacerbation of ulcerative colitis suggesting that repeated replacement of the body's iron stores is often necessary in this disease.

Control of the hyperdynamic circulation in patients with bleeding esophageal varices

Images

Pyrexia and elevated erythrocyte sedimentation rate in acute gastro-duodenal haemorrhage

Rises in the body temperature and the erythrocyte sedimentation rate (ESR) in the absence of significant associated disease, were each observed in one-third of a large series of patients with acute gastro-duodenal haemorrhage.

While only 15% of the patients showed both a pyrexial reaction and a rise in the ESR, fully 55% of the cases showed one or the other abnormality.

There was no significant difference in the incidence of these abnormalities in haematemesis from chronic duodenal ulcer, chronic gastric ulcer or acute gastric erosion and the rise in the ESR showed no signficant correlation with the severity of bleeding.