Surgical management of bleeding gastric and duodenal ulcer-with special reference to indications for operation-.

A total of 79 cases with bleeding gastric and / or duodenal ulcers subjected to operation were retrospectively reviewed with special reference to indications for.operation. The results are as follows: (1) The 79 bleeding ulcer cases, sharing 15.6% of all operated patients with gastric and / or duodenal ulcer, consisted of 49 with gastric ulcer, 21 with duodenal ulcer, and 9 with coexisting ulcer. Emergency operations were performed in 20 (25.3%) of the 79 cases; (2) Shock complicated in 31 (39.2%) of the 79 cases revealed its incidence higher in the emergency operation, i.e., in 9 (45%) of the 20 cases; (3) Operative mortality was also higher in rate for the emergency operation cases, 4 deaths (20%) out of 20, than for all bleeding ulcer cases, 7 deaths (8.9%) out of 79 cases. Five of the 7 operative deaths were in patients over 60 years of age; (4) Emergency or elective operation should be finally decided after a careful examination on the patient's general conditions, paying regard to ages, actual and opssible rebleeding, and coexistent diseases; emergency operation should be considered if adequate transfusion proves unsuccessful in relieving shock or rebleeding. [ABSTRACT FROM AUTHOR]